Laparoscopic cholecystectomy with communicating accessory hepatic duct injury and management: A case report.

Abstract

Background: Laparoscopic cholecystectomy is considered the gold standard for the treatment of patients with gallstones. However, bile duct injury is one of the most serious complications of this surgery, with an incidence rate of 0.3%-0.7%. Variations in anatomical structures are one of the main reasons for such injuries.

Case summary: We report a 26-year-old male patient who presented with repeated upper abdominal pain for 1 year. Ultrasound examination and blood tests indicated gallstones accompanied by chronic cholecystitis. The patient underwent laparoscopic cholecystectomy. During the surgery, a communicating bile duct connecting the gallbladder neck and the right hepatic duct was discovered and injured. Meticulous dissection identified it as a communicating accessory hepatic duct, which was then definitively ligated. Postoperatively, the patient recovered well, magnetic resonance imaging and magnetic resonance cholangiopancreatography showed no intrahepatic or extrahepatic bile duct strictures. The pathology report showed chronic cholecystitis with gallstones.

Conclusion: Carefully manage communicating accessory bile ducts in cholecystectomy using cholangiography or meticulous separation, followed by ligation is effective.