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Title: A case of mistaken identity: bile duct masquerading as gallbladder.
Authors: Jolly S
Kundu N
Rathnayake S
Citation: Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2023.
J Surg Case Rep. 2023 Jan 19;2023(1):rjad001. doi: 10.1093/jscr/rjad001. eCollection 2023 Jan.
Abstract: Laparoscopic cholecystectomy is a common surgical procedure, with potential for significant morbidity. The incidence of bile duct injuries has increased with the advent of laparoscopy, occurring in up to 1% of cases. Risk of injury increases with aberrant anatomy, acute inflammation and fibrosis. Preventative strategies include obtaining the critical view of safety, using a fundus-first approach and performing a subtotal cholecystectomy in the difficult gallbladder. Although controversy exists for routine cholangiography, its use is helpful in situations of obscure anatomy. We describe the case of a chronically inflamed and unusually small 1.5 cm gallbladder with an obliterated cystic duct. The critical view of safety was not able to be achieved and intraoperative cholangiography enabled identification of aberrant anatomy, with a dilated common duct mistaken as the gallbladder infundibulum. This case highlights the need to be vigilant to structural variation and the utility of selective cholangiography to clarify anatomy.
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Journal title: Journal of surgical case reports
Volume: 2023
Pages: rjad001
Publication Date: 2023-01-19
Type: Case Reports
Case Reports
DOI: 10.1093/jscr/rjad001
Orcid: 0000-0002-7674-508X
Appears in Collections:(a) NT Health Research Collection

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