DIFFERENT ANATOMY OF EXTRAHEPATIC BILE DUCT IN PATIENTS WITH CALCULOUS CHOLECYSTITIS: CLINICAL OBSERVATIONS

Summary. The aim of investigation – to get acquainted with the possibilities variant anatomy extrahepatic bile ducts location.
 Results and their discussion. In our own practice, we observed two patients atypical anatomy.
 Patient G. was operated because chronic calculous cholecystitis. During laparoscopic cholecystectomy, encountered following situation: it found that gallbladder has a very short duct directly in region portal liver. After dissection d. cysticus flows into right hepatic duct. Timely establishment this anatomy, which achieved by careful junction area hepaticus dexter, allowed prevent (in case) wrong clipping example possibility timely establishing presence anatomical features made possible damage.
 K. cholecystitis, choledocholithiasis (without clinical laboratory signs mechanical jaundice). established patient ducts, when drains gallbladder. This anomaly discovered after separation from its bed, as result damaged. access conversion performed, place exit liver anomalous established. order restore outflow bile, right-sided hepaticojejunostomy performed on Roux loop, external drainage choledoch according Ker, abdominal cavity.
 Conclusions. Although cholecystectomy is standard routine operation, variability location should be considered.
 We consider expedient during transition vesical hepaticocholedoch carefully isolate all structures until absolute identification.