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Surgical Endoscopy

Published in:

01-07-2006

Preoperative evaluation of the extrahepatic bile duct structure for laparoscopic cholecystectomy

Authors: K. Uchiyama, M. Tani, M. Kawai, M. Ueno, T. Hama, H. Yamaue

Published in: Surgical Endoscopy | Issue 7/2006

Abstract

Background

The incidence of aberrant bile duct injury associated with laparoscopic cholecystectomy (LC) has not yet been adequately examined. This study aimed to clarify the types of normal cystic ducts and the incidence of aberrant extrahepatic bile ducts, and to search for a method of avoiding injuries during LC.

Methods

Aberrant hepatic ducts were retrospectively categorized into five types according to the pattern of the cystic ducts and the accessory hepatic ducts by preoperative endoscopic retrograde cholangiography or multidetector three-dimensional computed tomography using drip infusion cholangiography. The aberrant bile ducts were classified as type A (merging at the right side of the common bile duct), type B (merging at the anterior side), or type C (merging at the posterior left side).

Results

The intrahepatic bile ducts and cystic duct were clearly shown for 1,044 of the 1,278 patients who underwent LC. Secondary branches of aberrant cystic ducts were observed in 37 cases (3.5%), and accessory hepatic ducts were observed in 30 cases (2.9%). A comparison of the difficulties encountered with LC for each type based on the merging patterns of cystic ducts showed that type C needed a much longer operation time for LC than the other types.

Conclusions

A preoperative evaluation of the bile duct tract and the accessory hepatic duct before LC is important. Patients with a cystic duct merging normally into the posterior left side of the common hepatic duct (type C) experienced difficulty when undergoing LC. The authors have safely performed LC with the use of an endoscopic nasobiliary drainage tube in type D cases (cystic duct merging with the right hepatic duct), in type IV cases (cystic duct merging with an accessory hepatic duct).

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Title: Preoperative evaluation of the extrahepatic bile duct structure for laparoscopic cholecystectomy
Authors: K. Uchiyama
M. Tani
M. Kawai
M. Ueno
T. Hama
H. Yamaue
Publication date: 01-07-2006
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 7/2006
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-005-0689-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Preoperative evaluation of the extrahepatic bile duct structure for laparoscopic cholecystectomy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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