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Attempted Cholecystectomy with Resulting Bile Duct Injuries

ID: exh75209a
This exhibit features three simplified enlarged anterior views of the biliary region including the gallbladder, biliary ducts, lower liver and a portion of the duodenum, as well as the various arteries of this region. These three views allow us to clearly compare the following conditions: Normal anatomy providing an overall orientation to the anatomy with each of the major structures labeled including the ducts and arteries. This view clearly shows how the gallbladder is connected to the common bile duct via the cystic duct; Proper post-operative condition with a clip on the cystic duct with the gallbladder and proximal cystic duct removed but all other structures untouched; Actual post-operative condition shows the common bile duct clipped below the level of the cystic duct with the proximal bile duct, common hepatic duct and right confluence of the hepatic ducts removed. The left hepatic duct is shown transected at the level of the liver, the stump of the right hepatic duct will extend out from the liver and a separate smaller aberrant hepatic duct will be shown. Each of these transected ducts is actively leaking bile. The The right hepatic artery is also transected.
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