How to Cite
Abstract
Today laparoscopic cholecystectomy is accepted as a golden standard in the treatment of calculous cholecystitis. Despite the fact, that the method has been widely used, according to the literature iatrogenic damage of bile ducts is seen in 0-2,7% of all cases. We present the case of 22 years old white female with the diagnosis of chronic calculous cholecystitis. Standard operation – laparoscopic cholecystectomy without any intraoperative complication had been performed. The patient was discharged on the second day after operation. Readmitted to the clinic on 4th postoperative day complaining on dull right sided abdominal pain and subfebrile temperature. Ultrasound revealed sub hepatic fluid collection. Laparotomy revealed that the fluid was bile and the reason of leakage was second cystic duct located 3-4 mm distally to the ligated one. The duct was opened with diameter 1,5-2 mm. The additional duct was ligated. Patient was discharged from clinic without any farther complications. The conclusion of the article is that anomaly in the area of Calot’s triangle can be the reason of iatrogenic damage of the bile duct even in case of not complicated laparoscopic cholecystectomy performed by skilled surgeon.
References
2. Н.А. МИЗУРОВ, А.Г. ДЕРБЕНЕВ, В.В. ВОРОНЧИХИН ОШИБКИ И ОСЛОЖНЕНИЯ ПРИ ОПЕРАЦИЯХ НА ЖЕЛЧЕВЫВОДЯЩИХ ПУТЯХ, 2010 https://giduv.com/journal/2010/1/ oshibki_i_oslozhnenija
3. Лебедев Д. Н. МОДЕЛИ И АЛГОРИТМЫ ПЕРИОПЕРАЦИОННОЙ ЛУЧЕВОЙ ВИЗУАЛИ¬ЗАЦИИ ЖЕЛЧЕВЫВОДЯЩИХ ПРОТОКОВ У БОЛЬНЫХ КАЛЬКУЛЕЗНЫМ ХОЛЕЦСТИТОМ 2008 http://www.dissercat.com/content/modeli-i-algoritmy-perioperatsionnoi-luchevoi-vizuali-zatsii-helchevyvodyashchikh-protokov
4. Г.В. Фомов, А.С. Мухин, Г.И. Подолинный, В.П. Горпинюк, В.В. Звягинцев, ФЕНОТИПИЧЕСКИЕ МАРКЕРЫ АНОМАЛИЙ АНАТОМИИ ТРЕУГОЛЬНИКА КАЛО 201 https://cyberleninka.ru/ article/n/fenotipicheskie-markery-anomaliy-anatomiitreugolnika- kalo
5. Тимербулатов В.М., Сагитов Р.Б., Сибаев В.М., Уразбахтин И.М., Гарипов Р.М., Бакиров Э.Р., Мусин Т.В.Особенности хирургической анатомии треугольника Calot и зоны Moosman при выполнении холецистэктомии (краткая илл¬юстрированная лекция) 2011 http://jecs.ru/view/108/
6. И.В. Шалаева, АНОМАЛИИ РАЗВИТИЯ ЖЕЛЧНОГО ПУЗЫРЯ И ЖЕЛЧЕВЫВОДЯЩИХ ПУТЕЙ 2016, http://www.liveinternet.ru/users/5729764/ post385893236/?aid_refresh=yes
7. А.П. Радзиховский1 , Н.А. Мендель1,2, К.В. Туманов. УЧЕТ АНАТОМИЧЕСКИХ ВАРИАЦИЙ РАСПОЛОЖЕНИЯ ПУЗЫРНОЙ АРТЕРИИ И ПУЗЫРНОГО ПРОТОКА ДЛЯ ПРОФИЛАКТИКИ ОСЛОЖНЕНИЙ ЛАПАРОСКОПИЧЕСКОЙ ХОЛЕЦИСТЭКТОМИИ. Украiнський Журнал Хiрургiї, 2011, № 3 (12). http://www.ujs.dsmu.edu.ua/ journals/2011-03/2011-03_21.pdf
8. Miguel A. Carbajo, MD, PhD, Juan C. Martín del Omo, MD, PhD, Jose I. Blanco, MD, PhD, Carmen Cuesta, MD, Fernando Martín, MD, PhD, Miguel Toledano, PhD, Ramon Atienza, MD, PhD, and Carlos Vaquero, MD, PhD. Congenital Malformations of the Gallbladder and Cystic Duct Diagnosed by Laparoscopy: High Surgical Risk. Journal of the Society of Laparoendoscopic Surgeons, 1999 Oct-Dec; 3(4): 319–321. https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC3015364/
9. Larobina M. and Nottle P.. Extrahepatic biliary anatomy at laparoscopic cholecystectomy: is aberrant anatomy important?//ANZ. J. Surg., 2005. - v.75.- p. 392-395