Biliary injury after laparoscopic cholecystectomy in a patient with right liver agenesis: Case report and review of the literature

An 87-year-old man underwent attempted laparoscopic cholecystectomy. The procedure was characterized by significant inflammation and bleeding requiring conversion to an open procedure. Postoperatively, the patient had continued bile drainage from his surgical drain. He was referred to our institution and found to have complete transection of his common bile duct. Incidentally, he was noted on imaging studies to have absence of his right liver with associated left liver hypertrophy. This was characterized by complete absence of the right portal vein and right bile duct. Review of his preoperative imaging confirmed this finding of right liver agenesis and very unusual hepatic vein anatomy. This represents the first reported case of bile duct injury in the setting of right liver agenesis. We review the details of the case and the natural history of agenesis of a hemiliver.