Management of aberrant bile duct during laparoscopic cholecystectomy.
OBJECTIVE
To investigate the incidence of aberrant bile duct and its management during laparoscopic cholecystectomy (LC).


METHODS
In 10 000 patients undergoing laparoscopic cholecystectomy from 1992 to July 2001, 3 had the involvement of the right accessory hepatic duct. In patient 1, the aberrant duct drained into the cystic duct was confirmed by open operation. In patient 2, the aberrant duct, which drained to the common bile duct (CBD), was injured and treated with suture and ligature under laparoscopy. In patient 3, the aberrant duct, which also drained to the CBD, was confirmed and preserved.


RESULTS
All patients recovered well except patient 1 who had a transient elevation of ALT. No bile leakage or other complication occurred.


CONCLUSIONS
Only variation near the confluence and the entrance of the cystic duct into the bile duct is discovered during laparoscopic cholecystectomy. Right accessory hepatic duct is common and should be preserved during the operation. The accidentally injured small accessory hepatic duct can be treated with ligature without severe disturbance to liver function.
Li
Ji-Hui
JH
Center of Minimal Invasive Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China. sunymike@online.sh.cn
Zheng
Cheng-Zhu
CZ
Ke
Chong-Wei
CW
Yin
Kai
K
D000328:Adult; D000368:Aged; D001652:Bile Ducts / Q000002:abnormalities*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies