A Type V Aberrant Right Hepatic Duct Branching from the Cystic Duct: The Paramount Importance of Intraoperative Cholangiography in Supplementing the Critical View of Safety Technique in Laparoscopic Cholecystectomy

CRSLS. 2022 Mar 28;9(2):e2022.00005. doi: 10.4293/CRSLS.2022.00005. eCollection 2022 Apr-Jun.

Abstract

In this report, we present a 38-year-old female with acute cholecystitis, in which an aberrant right hepatic duct draining directly into the cystic duct was revealed by intraoperative cholangiography during a laparoscopic cholecystectomy. This anomaly was classified as the class V variant using the Hisatsugu classification schema, which has an incidence of 1.02%. The use of Strasberg's critical view of safety has become ubiquitous in laparoscopic cholecystectomy. Intraoperative cholangiography provides and additional layer of safety, and should be considered as a routine practice, particularly when imaging to delineate biliary anatomic aberrancies has not been performed prior to surgery.

Keywords: Aberrant right hepatic duct; Cholangiography; Critical field of view; Laparoscopic cholecystectomy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Biliary Tract*
  • Cholangiography / methods
  • Cholecystectomy, Laparoscopic* / adverse effects
  • Cystic Duct / diagnostic imaging
  • Female
  • Hepatic Duct, Common / abnormalities
  • Humans