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Case Reports
. 2017 May 31;2017(5):rjx087.
doi: 10.1093/jscr/rjx087. eCollection 2017 May.

A rare anatomical variation of the biliary tree

Ioannis D Kostakis  1 , Themistoklis Feretis  1 , Paraskevas Stamopoulos  1 , Zoe Garoufalia  1 , Dimitrios Dimitroulis  1 , Stylianos Kykalos  1 , Gregory Kouraklis  1 , Gerasimos Tsourouflis  1
Affiliations
Case Reports

A rare anatomical variation of the biliary tree

Ioannis D Kostakis et al. J Surg Case Rep. .

Abstract

A 31-year-old woman was admitted to our department in order to undergo a laparoscopic cholecystectomy. The operation was converted to open due to cholorrhea during the dissection in the hepatocystic triangle. The cholorrhea came from a transected bile duct, which was 2 mm in diameter, came out of the hepatoduodenal ligament, ran along the common hepatic duct and drained into the cystic duct, in proximity to the neck of the gallbladder. The gallbladder was removed and an intraoperative cholangiography revealed that the aberrant bile duct was originated from the right posterior sectoral duct (RPSD). The RPSD continued its typical course up to its confluence with the right anterior sectoral duct and the formation of the right hepatic duct. This is a rare type of aberrant bile duct, which is added to the long catalogue of the anatomical variations of the biliary tree.

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Figures

Figure 1:
Figure 1:
Intraoperative cholangiography. Short white arrow: the origin of the aberrant bile duct from the RPSD. Long white arrow: the stump of the cystic duct. Short red arrow: RHD. Long red arrow: LHD. Long black arrow: CHD. Short black arrow: CBD. Forceps 1 holds the stump of the aberrant bile duct. Forceps 2 holds the stump of the cystic duct. Forceps 3 blocks the CBD for the intraoperative cholangiography.
Figure 2:
Figure 2:
Operating field after the removal of the gallbladder. Short black arrow: the stump of the aberrant bile duct. Long black arrow: the stump of the cystic duct. Long white arrow: CHD. Short white arrow: CBD.
Figure 3:
Figure 3:
Schematic representation of the patient's biliary tree. The part of the extrahepatic biliary tree that was removed during the operation (the gallbladder, part of the cystic duct and part of the aberrant duct) is illustrated with red color. Short thin red arrow: the aberrant bile duct. Long thin red arrow: cystic duct. Long thick white arrow: gallbladder. Short thick white arrow: RPSD. Short thin black arrow: RHD. Long thin black arrow: LHD. Long thick black arrow: CHD. Short thick black arrow: CBD.
See this image and copyright information in PMC

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