Right hepatic artery encircle the gallbladder: a case report
Detailed knowledge of the vascular anatomy of hepatobiliary system is important for a safe cholecystectomy. We are reporting a case of aberrant type of right hepatic artery originating from superior mesenteric artery and encircles the gallbladder that has been found during laparoscopic cholecyste...
| Main Authors: | , |
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| Format: | Article |
| Language: | English English |
| Published: |
Kulliyyah of Medicine, International Islamic University Malaysia
2019
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| Online Access: | http://irep.iium.edu.my/76260/ http://irep.iium.edu.my/76260/ http://irep.iium.edu.my/76260/1/76260_Right%20hepatic%20artery%20encircle%20the%20gallbladder.pdf http://irep.iium.edu.my/76260/2/76260_Right%20hepatic%20artery%20encircle%20the%20gallbladder_SCOPUS.pdf |
| Summary: | Detailed knowledge of the vascular anatomy of hepatobiliary system is important for a safe
cholecystectomy. We are reporting a case of aberrant type of right hepatic artery originating from
superior mesenteric artery and encircles the gallbladder that has been found during laparoscopic
cholecystectomy operation. We presented a 39-year-old Malay lady came to International Islamic
University Malaysia Medical Centre with features of obstructive jaundice. Ultrasound of
hepatobiliary system showed cholelithiasis with choledocholithiasis causing dilatation of the
common bile duct. ERCP had been performed and sphincterotomy was done. Patient was planned
for laparoscopic cholecystectomy. Intraoperatively, the Calot’s triangle was identified in usual
manner. However, the right hepatic artery was identified encircling the gallbladder body anteriorly
before entering the liver. The procedure was converted to open cholecystectomy due to anatomical
variation via Kocher’s incision. Further identification upon open cholecystectomy revealed right
hepatic artery originates from superior mesenteric artery runs anterior to cystic duct and encircles
the gallbladder before further branches into right and left lobe of the liver. Right hepatic artery
was dissected from the gallbladder and the gallbladder removed after cystic duct ligation and
separation from the liver bed. On table cholangiogram showed distal CBD stone which was pushed
down to duodenum with forceps? Post-operative was uneventful and patient liver functions
improved. Knowledge regarding anatomical structure and variant of hepatic artery as well as cystic
artery and cystic duct is important to ensure the inadvertent ligation of right hepatic artery which
would leads to hepatic ischemia and necrosis. |
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