Moynihan's Lump as an unusual variant of right hepatic artery during a laparoscopic cholecystectomy approach. A case report

Laparoscopic cholecystectomy is a very frequent surgical procedure with a low complication rate. The reasons for such complications range from anatomical anomalies, obesity, poor exposure of anatomic structures, bleeding or lack of surgical experience. If complications arise, prompt recognition and correct management are essential. Early and correct treatment allows avoidance of serious complications, such as secondary biliary cirrhosis, hepatic failure, and ultimately death. In this paper is presented a case of a 40-years-old male patient, who sustained iatrogenic major bile duct, right hepatic artery and duodenum injury during routine laparoscopic cholecystectomy due to symptomatic gallstones.

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Abnormal right hepatic artery injury resulting in right hepatic atrophy: diagnosed by laparoscopic cholecystectomy

Open Medicine ◽

10.1515/med-2015-0090 ◽

2015 ◽

Vol 10 (1) ◽

Cited By ~ 1

Author(s):

Valter Martino ◽

Alessia Ferrarese ◽

Marco Bindi ◽

Silvia Marola ◽

Valentina Gentile ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Case Report ◽

Hepatic Artery ◽

Vascular Lesions ◽

Biliary Surgery ◽

Right Hepatic Artery ◽

Hepatic Atrophy ◽

Hepatic Artery Injury ◽

Asymptomatic Case ◽

The Right

Abstract An intact hepatic artery is the gateway to successful hepato-biliary surgery. Introduction of laproscopic cholecystectomy (LC) has stimulated a renewed interest in the anatomy of hepatic artery. In this case report we have highlighted importance of variations of right hepatic artery in terms of origin and course We present a rare asymptomatic case of liver atrophy due to an intraoperative lesion of right hepatic artery. We also performed a literature review about surgical vascular lesions and tried to confirm the right concept behind “non trivial procedure” of the LC.

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Right Hepatic Artery Encircle the Gallbladder: A Case Report

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v18i1.811 ◽

2019 ◽

Vol 18 (1) ◽

Author(s):

Hanis M ◽

Nasser A

Keyword(s):

Laparoscopic Cholecystectomy ◽

Superior Mesenteric Artery ◽

Hepatic Artery ◽

Cystic Duct ◽

Mesenteric Artery ◽

Open Cholecystectomy ◽

Right Hepatic Artery ◽

Hepatobiliary System ◽

Duct Ligation ◽

Cholecystectomy Operation

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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