Although reported that most guidewire perforations can be managed medically with little morbidity, but laparoscopic control and intraoperative cholangiography seeking for any macro-perforation and repairing and early aggressive surgery may improve patient care. Pre-cut sphincterotomy is also a risk factor for perforation. In this case we found very low conjunction of CD to CBD and cystic artery from replaced right hepatic artery.
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