Double cyst duct in a young woman with a history of systemic lupus: A case report.

IF 0.6 Q4 SURGERY International Journal of Surgery Case Reports Pub Date : 2024-11-01 Epub Date: 2024-10-16 DOI:10.1016/j.ijscr.2024.110459
Salvador Carlos Jiménez, Miriam Natividad Jiménez Velázquez, Juan Carlos Rivera Nava, Raúl Alejandro Núñez Torres, Edgard Efrén Lozada Hernández, Jose Alaniz Ruiz
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Abstract

Introduction and importance: Cholecystectomy is the most common general surgery procedure, necessitating thorough knowledge of bile duct anatomy. Despite the bile duct's anatomical diversity, reports of double cystic ducts are rare. This case presentation aims to emphasize the importance of recognizing this unusual anatomical variant during surgical procedures to prevent complications and ensure patient safety.

Case presentation: This is a 22-year-old woman with a history of lupus. Initial clinical and ultrasound evaluations concluded she had cholangitis, choledocholithiasis, and cholecystitis. A cholecystectomy was performed, during which a double cystic duct was identified and confirmed with intraoperative cholangiography. Five days after surgery, the patient exhibited increased bilirubin levels, and a follow-up cholangiography showed dilation of the common bile duct with no passage of contrast medium into the duodenum. She underwent ERCP with endoprosthesis placement and is currently under follow-up with adequate progress.

Clinical discussion: Double cystic ducts are extremely rare anatomical variants. These variations pose significant challenges for surgeons during surgery, emphasizing the need for a universal culture of safety during cholecystectomy. Although this anatomical variant is rare, surgeons must be aware of it. Given the uncertainty of anatomy, it is advisable to perform intraoperative imaging, such as cholangiography, before sectioning any duct.

Conclusion: Double cystic duct variations are rare, but when bile duct anatomy is unclear, intraoperative cholangiography is essential. This technique improves visualization of biliary structures, aiding informed decisions before duct ligation and reducing the risk of bile duct disruption.

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一名有系统性红斑狼疮病史的年轻女性体内的双囊肿导管:病例报告。
导言和重要性:胆囊切除术是最常见的普外科手术,需要对胆管解剖有透彻的了解。尽管胆管的解剖结构多种多样,但双囊管的报告却很少见。本病例旨在强调在外科手术中识别这种异常解剖变异的重要性,以防止并发症的发生,确保患者安全:这是一名 22 岁的女性,有红斑狼疮病史。初步临床和超声波评估认为她患有胆管炎、胆总管结石和胆囊炎。她接受了胆囊切除术,术中发现并通过术中胆管造影确认了双囊管。术后五天,患者胆红素水平升高,随访胆管造影显示胆总管扩张,造影剂未进入十二指肠。她接受了ERCP,并置入了假体,目前正在接受随访,进展良好:临床讨论:双胆囊管是极其罕见的解剖变异。临床讨论:双胆囊管是一种极其罕见的解剖变异,在手术过程中给外科医生带来了巨大挑战,强调了胆囊切除术中普遍安全文化的必要性。虽然这种解剖变异非常罕见,但外科医生必须意识到这一点。鉴于解剖结构的不确定性,建议在切开任何导管之前进行术中成像,如胆管造影:结论:双胆管变异非常罕见,但当胆管解剖结构不清楚时,术中胆管造影是必不可少的。这项技术可改善胆管结构的可视化,有助于在结扎胆管前做出明智的决定,并降低胆管破坏的风险。
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来源期刊
CiteScore
1.10
自引率
0.00%
发文量
1116
审稿时长
46 days
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