Aberrant Bile Duct Complicated with Gallstone Disease -Laparoscopic Cholecystectomy Performed for Pulling Tape Method-

Takao Ichihara, Satoaki Mitsutsuji, Tomoaki Urakawa

Department of Surgery, Kobe Rosai Hospital of the Labor Welfare Company

We report 2 patients who had an aberrant bile duct entering the cystic duct. Though in one of the two cases its existence was not confirmed before the operation, laparoscopic cholecystectomy was successfully performed without injury to the aberrant bile duct. In many hospitals, laparoscopic cholecystectomy involves initial dissection and transection of the cystic duct which is then divided from the gallbladder approaching from the corpus upward. As laparoscopic cholecystectomy has become widely practiced, it is important to perfrom the procedure with proper recognition of bile duct anomalies. We can not, however, consistently achieve this in all cases. We perform laparoscopic cholecystectomy by the pulling tape technique, such that we first bind the cystic duct with tape after having divided it from the corupus of gallbladder. It is important to maintain the structure without dissection or transection. Next, we perform cholecystectomy approaching from the fundus downward. Indeed, approaching from the fundus downward has the demerit of a less than optimal orientation of Calot's triagle as compared to approaching from the corpus upward, but our method facilitates obtaining a good view of Calot's tringle by pulling down the tape and the fundus of the gallbladder. We consider these two cases to have been done safely by this technique, performed with surgical expertise.

Key words
laparoscopic cholecystectomy, aberrant bile duct

Reprint requests
Takao Ichihara Department of Surgery, Kobe Rosai Hospital
4-1-23 Kagoike-dori, Tyuo-ku, Kobe, 651 JAPAN

Accepted
September 11, 1996

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