Unintentional dissection of the common bile duct
Epublication WebSurg.com, Apr 2015;15(04). URL: http://websurg.com/doi/vd01en4460
This video demonstrates the case of an 81-year-old woman with chronic cholecystitis. She has had several episodes of right hypochondrium pain with altered liver tests, which spontaneously got back to normal values. Ultrasound and CT-scan demonstrated the presence of uncomplicated gallstones and a slightly hypotonic common bile duct (8mm in diameter). No obstacle was visualized in the common bile duct. A delayed laparoscopic cholecystectomy was scheduled. This video shows how some inaccuracies in the dissection technique and the presence of an altered anatomy have led to a circumferential dissection of the common bile duct. Common bile duct injury was avoided and the importance of an intraoperative cholangiography is emphasized.