Duct Luschka: an anatomic variation of biliary tree detected during cholecystectomy
DOI:
https://doi.org/10.11606/issn.1679-9836.v102i1e-195137Keywords:
Duct of lushka, Bile duct, CholecystectomyAbstract
The Luschka duct is an anatomical alteration that is not easily identified in the preoperative imaging exams. Knowledge of the anatomy and the possibility of finding this anatomical structure provides greater safety in the surgical procedure. The case described addresses an intraoperative biliary leak due to the presence of the Luschka duct during an open cholecystectomy and its management. Objective: To describe the case of a patient with cholelithiasis, submitted to a conventional cholecystectomy in an elective manner, in which the presence of the Luschka duct was detected intraoperatively, as well as the surgical and clinical management of the case. Result: The patient underwent cavitation drainage intraoperatively, as well as duct ligation. She presented good evolution in the following days, with clinical improvement, and was discharged from the hospital in good condition on the 4th postoperative day. Discussion: The Luschka duct is one of the most common anatomical variations of the biliary tree. The identification of this duct in the preoperative period is extremely difficult and rare, and its surgical treatment usually consists of lavage of the abdominal cavity, closure of the Luschka duct and intraoperative cholangiography to confirm that the biliary tree is intact. Conclusion: The importance of knowledge and surgical and clinical management of this anatomical structure is important for a good evolution of the patient.
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Boonstra EA, Lorenz K, Porte RJ. The quest for Luschka’s duct: an eponym leading a life of its own? Dig Surg. 2014;31(2):104-107. doi: https://doi.org/10.1159/000362095
Tabanera AV, Vicente AP, Buenadicha AL, Peromingo R, Hervás PL, Vasquez-Garza, JN. Luschka duct leak: An unexpected cause of choleperitoneum after liver transplant. Exp Clin Transplant. 2020;18(4):526-28. doi: https://doi.org/10.6002/ect.2018.0348
Amar AO, Kora C, Jabi R, Kamaoui I. The Duct of Luschka: an anatomical variant of the biliary tree–two case reports and a review of the literature. Cureus. 2021;13(4). doi: https://doi.org/10.7759/cureus.14681
Abdalla S, Pierre S, Ellis H. Calot’s triangle. Clin Anat. 2013;26(4):493-501. doi: https://doi.org/10.1002/ca.22170
Harada N, Sugawara Y, Ishizawa T, Kaneko J, Sakamoto Y, Aoki T, et al. Resection of hepaticocystic duct which is a rare anomaly of the extrahepatic biliary system: a case report. J Med Case Rep. 2013;7(1):1-3. doi: https://doi.org/10.1186/1752-1947-7-279
Ko K, Kamiya J, Nagino M, Oda K, Yuasa N, Arai T, et al. A study of the subvesical bile duct (duct of Luschka) in resected liver specimens. World J Surg. 2006;30(7):1316-1320. doi: https://doi.org/10.1007/s00268-005-0469-z
Sharif K, de Goyet, JDV. Bile duct of Luschka leading to bile leak after cholecystectomy—revisiting the biliary anatomy. J Pediatr Sur. 2003;38(11):E21-E23. doi: https://doi.org/10.1016/j.jpedsurg.2003.08.008
Crowley C, Elojeimy S, Rieter WJ. Utility of dynamic hepatobiliary scintigraphy in identifying a duct of Luschka bile leak. Clin Nuclear Med. 2021;1-1. doi: https://doi.org/10.1097/RLU.0000000000003928
Ramia JM, Muffak K, Mansilla A, Villar J, Garrote D, Ferron, JA. Postlaparoscopic cholecystectomy bile leak secondary to an accessory duct of Luschka. JSLS. 2005;9(2):216-217. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3015576/
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Copyright (c) 2023 Olival Cirilo Lucena da Fonseca Neto, Beatriz Costa Nava Martins, Maria das Graças Lapenda Pedrosa
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