PDF(Pubmed)
Abstract：
Anatomical variations of the biliary tree pose diagnostic and treatment challenges. While most are harmless and often discovered incidentally during procedures, some can lead to clinical issues and biliary complications, making knowledge of these variants crucial to prevent surgical mishaps. Here, we present an unusual and clinically significant case. A 61-year-old man is admitted to the hospital with epigastric pain and diagnosis of pancreatitis of biliary origin and intermediate risk of choledocholithiasis. Magnetic resonance cholangiopancreatography (MRCP) reported hepatolithiasis and choledocholithiasis, whereas endoscopic retrograde cholangiopancreatography showed cystic drain of the right hepatic duct. One month later the patient presented again to the emergency room with increasing abdominal pain and a computed tomography that demonstrated the presence of hepatic abscess and acute cholecystitis. The patient underwent percutaneous drain abscess and a subtotal laparoscopic cholecystectomy. Biliary anatomical variants present challenges on the diagnostic investigations, interventional and surgical procedures, understanding the possible complications is essential.
摘要：
胆道树的解剖变异给诊断和治疗带来了挑战。虽然大多数是无害的，并且经常在手术过程中偶然发现，有些会导致临床问题和胆道并发症，使这些变体的知识对于防止手术事故至关重要。这里,我们提出了一个不寻常且具有临床意义的病例.一名61岁的男子因上腹痛和胆源性胰腺炎的诊断和胆总管结石的中等风险而入院。磁共振胰胆管成像（MRCP）报告肝胆管结石和胆总管结石，而内镜逆行胰胆管造影术显示右肝导管囊性引流。一个月后，患者再次出现腹痛，并进行计算机断层扫描，显示存在肝脓肿和急性胆囊炎。患者接受了经皮脓肿引流和腹腔镜胆囊切除术。胆道解剖变异对诊断研究提出了挑战，介入和外科手术，了解可能的并发症至关重要。
