# Application of fluorescent cholangiography to complex biliary variants of the confluence of the cystic duct and the infraportal type of the left lateral bile duct during single‐incision laparoscopic cholecystectomy: A case report

## TL;DR

A case report shows how fluorescent cholangiography helped safely perform a complex cholecystectomy in a patient with unusual bile duct anatomy.

## Contribution

Demonstrates the utility of fluorescent cholangiography in managing complex biliary variants during minimally invasive surgery.

## Key findings

- Fluorescent cholangiography successfully visualized a rare biliary anatomy variant during surgery.
- The cystic duct joined the infraportal left lateral bile duct without a left hepatic duct formation.
- The procedure enabled safe dissection of the cystic duct in a high-risk anatomical scenario.

## Abstract

A 21‐year‐old man was diagnosed with segmental adenomyomatosis of the gallbladder based on ultrasonography and computed tomography images. Computed tomography with drip infusion cholangiography revealed that the cystic duct joined the infraportal type of the left lateral bile duct (IPLLBD), which runs caudal to the umbilical portion, and that the left medial bile duct joined the right hepatic duct without forming the left hepatic duct. We planned a single‐incision laparoscopic cholecystectomy with fluorescent cholangiography. The fluorescent cholangiography visualized the anatomic variant of the biliary system, and the cystic duct was divided safely. Fluorescent cholangiography is a suitable procedure to depict complex biliary anatomic variations in this patient. IPLLBD without the formation of the left hepatic duct is potentially hazardous during cholecystectomy.