Hepaticocystic Duct in an Era of Laparoscopic Cholecystectomy
The biliary tract is notorious for its variable anatomy. A persistent hepaticocystic duct with agenesis of common bile duct is a rare biliary anomaly that creates a diagnostic dilemma and can add to the operative difficulties. It is important to diagnose this anomaly preoperatively since the gallbla...
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Thieme Medical Publishers, Inc.
2021-07-01
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doaj-ce27bed6c69a4f3ea28e2267023db8912021-07-20T00:27:34ZengThieme Medical Publishers, Inc.The Surgery Journal2378-51282378-51362021-07-010703e138e14110.1055/s-0041-1731428Hepaticocystic Duct in an Era of Laparoscopic CholecystectomyJignesh A. Gandhi0Pravin Shinde1Sadashiv N. Chaudhari2Amay Banker3Department of General Surgery, Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, IndiaDepartment of General Surgery, Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, IndiaDepartment of General Surgery, Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, IndiaDepartment of General Surgery, Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, IndiaThe biliary tract is notorious for its variable anatomy. A persistent hepaticocystic duct with agenesis of common bile duct is a rare biliary anomaly that creates a diagnostic dilemma and can add to the operative difficulties. It is important to diagnose this anomaly preoperatively since the gallbladder forms an integral part of bilioenteric continuity and an inadvertent cholecystectomy can lead to a surgical catastrophe. If diagnosed, surgeons can plan definitive treatment in the form of biliary diversion. We present a case of a 22-year-old man, who presented to us with obstructive jaundice and cholangitis. The biliary system was decompressed initially with a percutaneous transhepatic biliary drainage and an endoscopic retrograde cholangiogram established the diagnosis of a type IV hepaticocystic duct preoperatively in our case. Since diagnosis was made prior to operative intervention, we were able to perform a cholecystojejunostomy to maintain biliary continuity. The patient was discharged with an uneventful postoperative course. To our knowledge, this is the first report of such a variation being diagnosed preoperatively. We are also presenting a brief review of literature about persistent hepaticocystic ducts and the embryological basis of their origin.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1731428hepaticocystic ductextrahepatic biliary treeagenesis of common bile duct |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jignesh A. Gandhi Pravin Shinde Sadashiv N. Chaudhari Amay Banker |
spellingShingle |
Jignesh A. Gandhi Pravin Shinde Sadashiv N. Chaudhari Amay Banker Hepaticocystic Duct in an Era of Laparoscopic Cholecystectomy The Surgery Journal hepaticocystic duct extrahepatic biliary tree agenesis of common bile duct |
author_facet |
Jignesh A. Gandhi Pravin Shinde Sadashiv N. Chaudhari Amay Banker |
author_sort |
Jignesh A. Gandhi |
title |
Hepaticocystic Duct in an Era of Laparoscopic Cholecystectomy |
title_short |
Hepaticocystic Duct in an Era of Laparoscopic Cholecystectomy |
title_full |
Hepaticocystic Duct in an Era of Laparoscopic Cholecystectomy |
title_fullStr |
Hepaticocystic Duct in an Era of Laparoscopic Cholecystectomy |
title_full_unstemmed |
Hepaticocystic Duct in an Era of Laparoscopic Cholecystectomy |
title_sort |
hepaticocystic duct in an era of laparoscopic cholecystectomy |
publisher |
Thieme Medical Publishers, Inc. |
series |
The Surgery Journal |
issn |
2378-5128 2378-5136 |
publishDate |
2021-07-01 |
description |
The biliary tract is notorious for its variable anatomy. A persistent hepaticocystic duct with agenesis of common bile duct is a rare biliary anomaly that creates a diagnostic dilemma and can add to the operative difficulties. It is important to diagnose this anomaly preoperatively since the gallbladder forms an integral part of bilioenteric continuity and an inadvertent cholecystectomy can lead to a surgical catastrophe. If diagnosed, surgeons can plan definitive treatment in the form of biliary diversion. We present a case of a 22-year-old man, who presented to us with obstructive jaundice and cholangitis. The biliary system was decompressed initially with a percutaneous transhepatic biliary drainage and an endoscopic retrograde cholangiogram established the diagnosis of a type IV hepaticocystic duct preoperatively in our case. Since diagnosis was made prior to operative intervention, we were able to perform a cholecystojejunostomy to maintain biliary continuity. The patient was discharged with an uneventful postoperative course. To our knowledge, this is the first report of such a variation being diagnosed preoperatively. We are also presenting a brief review of literature about persistent hepaticocystic ducts and the embryological basis of their origin. |
topic |
hepaticocystic duct extrahepatic biliary tree agenesis of common bile duct |
url |
http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1731428 |
work_keys_str_mv |
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