Resection of hepaticocystic duct which is a rare anomaly of the extrahepatic biliary system: a case report
- PDF / 1,423,821 Bytes
- 3 Pages / 595.276 x 793.701 pts Page_size
- 24 Downloads / 179 Views
CASE REPORT
JOURNAL OF MEDICAL
CASE REPORTS Open Access
Resection of hepaticocystic duct which is a rare anomaly of the extrahepatic biliary system: a case report Nobuhiro Harada, Yasuhiko Sugawara*, Takeaki Ishizawa, Junichi Kaneko, Yoshihiro Sakamoto, Taku Aoki, Kiyoshi Hasegawa and Norihiro Kokudo
Abstract Introduction: There are several variations in the morphologic characteristics of the extrahepatic biliary system. A hepaticocystic duct is one of the rare variations. Case presentation: A 69-year-old Asian man underwent a cholecystectomy for cholelithiasis. His cystic duct was not detected during surgery. An intraoperative cholangiography revealed that his common hepatic ducts drained directly into the neck of his gallbladder. There was no common bile duct, as evidenced by the union of the common hepatic and cystic ducts. Conclusion: Knowledge of anomalies related to the extrahepatic biliary system is important for decreasing the severe morbidity and mortality that may result from a failure to recognize the anomaly. Keywords: Abnormalities of the cystic duct, Anomaly, Biliary system, Cholecystectomy, Cholecystohepatic, Hepaticocystic
Introduction There are various anomalies of the extrahepatic biliary tree. In 1882, the surgical anatomy of the area was investigated with the advent of cholecystectomy. The lack of awareness of such anomalies during surgery of the biliary system may result in iatrogenic injuries. Here we describe a case in which a patient with a hepaticocystic duct underwent cholecystectomy. Case presentation A 69-year-old Asian man was admitted to our hospital for complaints of epigastric pain. There had been no nausea, vomiting, or melena. At the age of 67, he had a femoral head replacement for aseptic necrosis of his femoral head, and had been treated with oral medicine for gout since the age of 65. A physical examination revealed no abnormal signs other than jaundice and mild fever. Laboratory data revealed elevated serum hepatobiliary enzyme levels (alanine aminotransferase 247IU/L, aspartate * Correspondence: [email protected] Hepatobiliary Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
transaminase 123IU/L, γ-guanosine triphosphate 803IU/L, total bilirubin 2.3mg/dL, direct bilirubin 1.2mg/dL), a white blood cell count of 10,200/μL, and serum C-reactive protein levels of 0.24mg/dL. Ultrasonography revealed dilatation of his intrahepatic bile duct and gallstones. Computed tomography revealed stones in his common bile duct. The diameter of the largest stone was 15mm. The wall of his gall bladder was not thickened (Figure 1). His common bile duct stones were removed by endoscopic retrograde cholangiopancreatography (ERCP) before surgery. ERCP revealed that the diameter of his common bile duct was 11mm and the size of the filling defect in his inferior common bile duct was 15 × 10mm. His intrahepatic bile duct was dilated because of t
Data Loading...
