Calot's triangle (or the cystohepatic triangle) is an anatomic space bounded superiorly by the inferior surface of the liver, laterally by the CD, and medially by the common hepatic duct
Right hepatic artery usually crosses posterior to common hepatic duct
The right and left hepatic ducts and proximal of the common hepatic duct
were involved in the mass, resulting in dilatation of intrahepatic ducts.
We present a case of a 78-year-old jaundiced male patient who sustained common hepatic duct
injury during laparoscopic cholecystectomy eight months earlier.
An ERCP was then performed revealing external common hepatic duct
obstruction at the neck of the gallbladder.
CT chest abdomen and pelvis was ordered which revealed a 3 x 5 cm mass arising from the apical segment of the upper lobe of right lung, a 1 cm peripheral nodule in upper lobe of left lung, a 2 cm mass along margin of pancreatic head causing obstruction to the common hepatic duct
resulting in diffuse intra hepatic biliary dilatation, and a mass in fundus of gall bladder invading into adjacent liver.
09%) including 6 cases of common BDI, 2 cases of common hepatic duct
injury, 1 case of right hepatic duct injury, 1 case of accessory right hepatic duct, 1 case of aberrant BDI 1 case of biliary stricture, 1 case of biliary duct perforation, 3 cases of hemobilia, and 4 cases of bile leakage.
However, other sites of obstruction were gallbladder, common hepatic duct
(CHD), and pancreas.
21 type A--bile leak from cystic duct stump or gallbladder bed; type B--aberrant right hepatic duct occlusion; type C--aberrant right hepatic duct transection; type D--partial (<50%) transection of a major bile duct; and type E-->50% transection or complete transection of a major bile duct (further subclassified as E1-->2 cm from the confluence of the left and right hepatic ducts; E2--<2 cm from confluence; E3--no common hepatic duct
remnant with an intact hepatic duct confluence; E4--destruction of the hepatic duct confluence; and E5--aberrant right sectoral duct in conjunction with an injury to the common hepatic duct
Intraoperative cholangiogram revealed normal filling of the intrahepatic ducts, common hepatic duct
, common bile duct, and cystic duct with normal flow into the duodenum.
One patient has required long-term balloon dilatation and stenting of a common hepatic duct
These drain into the left and right hepatic ducts, which join to form the common hepatic duct