Common hepatic duct stenosis secondary to an absorbable ligation clip following laparoscopic cholecystectomy: A case report.

RATIONALE: Cystic duct (CD) variations are common biliary tract alterations; therefore, caution is required in the diagnosis and treatment of cholelithiasis in patients with gallbladder duct anomalies. Laparoscopic cholecystectomy (LC) is the preferred method for treating cholelithiasis or cholecystitis. Accurate preoperative imaging assessment, a thorough understanding of relevant surgical anatomy, and intraoperative precautions are required to effectively reduce the incidence of intraoperative bile duct injury.

PATIENT CONCERNS: We report the case of a 59-year-old male patient with common hepatic duct (CHD) stricture following LC. The patient's CD entered the common bile duct from the left side and ran ventrally around the common bile duct. Postoperative examination revealed partial stenosis of the CHD caused by compression from an absorbable ligation clip and transient hyperbilirubinemia. Fortunately, prompt treatment prevented serious complications.

DIAGNOSES: Cholelithiasis with cholecystitis and CD anatomical variation.

INTERVENTIONS: LC.

OUTCOMES: Postoperative examination revealed partial stenosis of the CHD caused by compression from an absorbable ligation clip, with transient hyperbilirubinemia. The patient was discharged 3 days postoperatively and followed up for 10 months. The absorbable ligation clips were resorbed, and the CHD stenosis resolved.

LESSONS: Biliary tract surgeons must understand and master common variations of the CD and their clinical significance. Potential anatomical variations should be identified preoperatively, while the extrahepatic bile ducts should be carefully exposed intraoperatively. Whenever possible, absorbable ligation clips should be used to transect the CD while avoiding compression of the bile duct to prevent bile duct injury.