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Impacted gallstone in the cystic duct is obstructing the common hepatic duct. Mirizzi's syndrome is a rare complication in which a gallstone becomes impacted in the cystic duct or neck of the gallbladder causing compression of the common hepatic duct, resulting in obstruction and jaundice.
Type VI: An isolated cyst of the cystic duct is an extremely rare lesion. Only single case reports are documented in the literature. The most accepted classification system of biliary cysts, the Todani classification, does not include this lesion. Cholecystectomy with cystic duct ligation near the common bile duct is curative. [5]
The investigation is usually conducted after an ultrasonographic examination of the abdominal right upper quadrant for a patient presenting with abdominal pain.If the noninvasive ultrasound examination fails to demonstrate gallstones, or other obstruction to the gallbladder or biliary tree, in an attempt to establish a cause of right upper quadrant pain, a cholescintigraphic scan can be ...
This procedure may be used if the stone is very large or if the duct anatomy is complex. [5] Typically, the gallbladder is then removed, an operation called cholecystectomy, to prevent a future occurrence of common bile duct obstruction or other complications. [6]
Biliary pain is most frequently caused by obstruction of the common bile duct or the cystic duct by a gallstone. However, the presence of gallstones is a frequent incidental finding and does not always necessitate treatment, in the absence of identifiable disease.
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Courvoisier's sign occurs due to the gradual (chronic) nature of the obstruction caused by cancer (e.g. pancreatic, often located in pancreatic head, cholangiocarcinoma, etc.), which gradually causes biliary back-pressure and gradually distends the gallbladder over time, without causing acute damage, thus without causing pain.
Common hepatic duct 5. Cystic duct 6. Common bile duct 7. Ampulla of Vater 8. Major duodenal papilla 9. Gallbladder 10–11. Right and left lobes of liver 12. Spleen 13. Esophagus 14. Stomach 15. Pancreas: 16. Accessory pancreatic duct 17. Pancreatic duct 18. Small intestine: 19. Duodenum
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