Prevention of bile duct injury in an aberrant right hepatic duct during laparoscopic cholecystectomy: A case report and literature review

Abstract

Cystic duct (CD) variation is challenging for surgeons performing biliary surgery. The misunderstanding of CD variants can lead to iatrogenic bile duct injuries (BDIs). We describe a 65-year-old man who presented with a 10-day history of abdominal pain and intermittent fever. He was admitted with the diagnosis of acute cholecystitis and underwent laparoscopic cholecystectomy during hospitalization. Intraoperatively, we found that the CD drained into the right hepatic duct rather than directly through the common bile duct, which is a very rare anatomic variation. This unusual case emphasizes the importance of recognizing this CD variation to avoid iatrogenic BDIs. This is particularly valuable for less experienced surgeons.