XXXX from the accessory biliary duct following laparascopic cholecystectomy.

@entity1 @entity154 @entity1157 @entity2963 @entity130
Anatomists and surgeons have described the presence of accessory biliary ducts between the liver and gallbladder. @entity1157 from accessory duct following laparoscopic cholecystectomy (LC) is an unusual post-operative complication. Aim of the study was to assess its incidence, the intraoperative methods helpful for notice the anatomical @entity154 and the impact of endoscopic procedure as a suitable treatment. From January 1997 to September 2002, 185 @entity1 underwent LC for symptomatic @entity2963 in our surgical department. Post-operative @entity1157 from accessory biliary duct occurred in two @entity1 (1%): one case from the liver bed of gallbladder (duct of Luschka) and one case from an aberrant cholecystohepatic duct entering Hartmann's pouch. One @entity1 underwent open celiotomy because of unavailability of endoscopic retrograde cholangiopancreatography. The other @entity1 was successfully treated by endoscopic sphincterotomy and nasobiliary tube placement. By careful dissection, accessory ducts were noticed and clipped in three other @entity1 with overall incidence of 2.7%. Meticulous laparoscopic technique aimed to careful recognize all structures during LC is the main policy to contain @entity130 within its nadir incidence. Depending of availability, endoscopic sphincterotomy and nasobiliary drainage allow diagnosis and treatment of @entity1157 , preserving the effectiveness of laparoscopic procedure.
