Wani Imtiaz
Department of Minimal Access and General Surgery Government Gousia Hospital, DHS Srinagar Kashmir India.
Clin Case Rep. 2025 Jul 1;13(7):e70593. doi: 10.1002/ccr3.70593. eCollection 2025 Jul.
Anatomical variations of the vascular supply of the hepatobiliary system are rare to see. A sound knowledge of congenital variations of vascular patterns in and around Calot's triangle is essential for the safe practice of laparoscopic cholecystectomy. A case of 34-year-old female is reported who has intraoperative diagnosis of Moynihan's hump, varices of paracholedochal plexuses, superficially placed portal vein in anterior plane with superficial course of inferior vena cava at Calot's triangle during laparoscopic cholecystectomy. An uneventful laparoscopic cholecystectomy was done with utmost meticulous approach and careful surgical dissection in Calot's triangle to avoid any inadvertent injury to anomalous vasculature. An occurrence of congenital anomaly of Moynihan's hump, varices of paracholedochal plexuses, superficially placed portal vein in anterior plane with superficial course of inferior vena cava at Calot's triangle is extremely rare and incidentally diagnosed intraoperatively. This case report is the first kind of case of world reporting occurrence of a multiple vascular anomalies diagnosed during laparoscopic cholecystectomy. Culture of safe practice of laparoscopic cholecystectomy is to be advocated and this is to be called as "Srinagar Cholecystectomy".
肝胆系统血管供应的解剖变异很少见。熟悉胆囊三角及其周围血管模式的先天性变异对于安全实施腹腔镜胆囊切除术至关重要。本文报道了一例34岁女性患者,在腹腔镜胆囊切除术中术中诊断为莫伊尼汉驼峰、胆管周围静脉丛曲张、胆囊三角前平面门静脉位置表浅且下腔静脉走行表浅。通过在胆囊三角采取极其细致的方法和仔细的手术解剖,顺利完成了腹腔镜胆囊切除术,以避免对异常血管造成任何意外损伤。莫伊尼汉驼峰先天性异常、胆管周围静脉丛曲张、胆囊三角前平面门静脉位置表浅且下腔静脉走行表浅的情况极为罕见,且在术中偶然被诊断出来。本病例报告是世界上首例报道在腹腔镜胆囊切除术中诊断出多种血管异常的病例。应提倡腹腔镜胆囊切除术的安全操作规范,并将其称为“斯利那加胆囊切除术”。