Subvesical bile duct and the importance of the critical view
Laparoscopic cholecystectomy is a common procedure in general surgery. The main challenges a surgeon may confront include inflammation, ductal and/or vascular injury, and aberrant anatomy.

A 59-year-old man underwent laparoscopic cholecystectomy for symptomatic cholelithiasis. Carboperitoneum was established using a standard open Hasson technique. Four laparoscopic ports were placed in standard fashion. During the procedure, the cystic duct and artery were dissected using the critical view of safety principle. After ligation and division of these structures, the gallbladder was carefully dissected with monopolar diathermy from its fossa in the liver. A subvesical bile duct was detected, originating from the right hepatic lobe/gallbladder fossa, draining into the gallbladder infundibulum. The duct was carefully dissected, controlled with clips, and divided. The patient had an uneventful recovery. Histopathological examination of the resected specimen confirmed the existence of the subvesical duct.

Source: International Journal of Surgery case reports

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