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Case Reports
. 2013 Apr-Jun;17(2):322-6.
doi: 10.4293/108680813X13693422521124.

Direct puncture cholangiography for clarifying difficult anatomy

M Ezzedien Rabie  1
Affiliations
Case Reports

Direct puncture cholangiography for clarifying difficult anatomy

M Ezzedien Rabie. JSLS. 2013 Apr-Jun.

Abstract

Laparoscopic cholecystectomy is a very frequently performed procedure. Its most dreadful complication is bile duct injury. Difficulty in appreciating the biliary anatomy plays an important role in its causation. Here we describe our technique in clarifying the difficult anatomy by directly injecting the radiologic contrast in the ambiguous area, and thus avoiding a potential injury.

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Figures

Figure 1.
Figure 1.
Extension of the lower part of the “gallbladder” behind the duodenum.
Figure 2.
Figure 2.
Injection of the contrast into what appeared to be the lower part of the gallbladder.
Figure 3.
Figure 3.
What appeared to be the gallbladder proved to be the common bile duct after contrast injection.
Figure 4.
Figure 4.
The gallbladder with L shaped configuration tapering down (white circle).
Figure 5.
Figure 5.
The injected contrast visualized the mucosal valves of the cyst duct.
See this image and copyright information in PMC

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