Department of Clinical Education, Taipei Tzu Chi Hospital, Buddhist Tzu, Chi Medical Foundation, New Taipei, Taiwan.
Department of Radiology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi, Medical Foundation, Chiayi, Taiwan.
CRSLS. 2021 Apr 1;8(1). doi: 10.4293/CRSLS.2020.00074. eCollection 2021 Jan-Mar.
We report a case of bile leaks post-laparoscopic cholecystectomy (LC) with initial treatment failure by common bile duct stent insertion. The injury of a subvesical duct running from gallbladder fossa toward an area of fluid accumulation that was not revealed by computed tomography and endoscopic retrograde cholangiopancreatography previously, was eventually found by magnetic resonance cholangiopancreatography (MRCP) and proved to be the cause of bile leak. Also, several tiny branches in the right liver instead of a main trunk and another subvesical duct draining into the common bile hepatic duct was noted. These anatomic variations were scarcely reported, especially by MRCP. The aim of this case report is to discuss the link between biliary tree anomaly and bile leak due to bile duct injury during LC in our experience treating one patient. Also, we review related literature to understand more on prevention or management of subvesical duct injury.
我们报告了一例腹腔镜胆囊切除术（LC）后胆漏病例，最初采用胆总管支架置入治疗失败。通过磁共振胰胆管成像（MRCP）发现，先前 CT 和内镜逆行胰胆管造影术未显示的从胆囊窝向积液区域运行的一条副胆囊管发生损伤，这被证明是胆漏的原因。此外，还发现右肝内有几个细小的分支而不是一个主干，以及另一条副胆囊管汇入胆总管。这些解剖变异很少有报道，尤其是通过 MRCP。本病例报告的目的是讨论在我们治疗的 1 名患者中，由于 LC 导致的胆管损伤，胆道异常与胆漏之间的关系。此外，我们还回顾了相关文献，以进一步了解预防或处理副胆囊管损伤的方法。
