Double cystic duct preoperatively diagnosed and successfully treated with laparoscopic cholecystectomy: A case report

Atsushi Fujii; Masatsugu Hiraki; Noriyuki Egawa; Hiroshi Kono; Takao Ide; Junichi Nojiri; Junji Ueda; Hiroyuki Irie; Hirokazu Noshiro

doi:10.1016/j.ijscr.2017.06.013

Double cystic duct preoperatively diagnosed and successfully treated with laparoscopic cholecystectomy: A case report

Int J Surg Case Rep. 2017:37:102-105. doi: 10.1016/j.ijscr.2017.06.013. Epub 2017 Jun 13.

Authors

Atsushi Fujii¹, Masatsugu Hiraki², Noriyuki Egawa³, Hiroshi Kono⁴, Takao Ide⁵, Junichi Nojiri⁶, Junji Ueda⁷, Hiroyuki Irie⁸, Hirokazu Noshiro⁹

Affiliations

¹ Department of Surgery, Faculty of Medicine, Saga University, Japan. Electronic address: afujii2003@yahoo.co.jp.
² Department of Surgery, Faculty of Medicine, Saga University, Japan. Electronic address: masatsuguhiraki@hotmail.com.
³ Department of Surgery, Faculty of Medicine, Saga University, Japan. Electronic address: egawa-noriyuki@live.jp.
⁴ Department of Surgery, Faculty of Medicine, Saga University, Japan. Electronic address: hkohno@med.kyushu-u.ac.jp.
⁵ Department of Surgery, Faculty of Medicine, Saga University, Japan. Electronic address: idetaka@cc.saga-u.ac.jp.
⁶ Department of Radiology, Faculty of Medicine, Saga University, Japan. Electronic address: junsatotaimiu@gmail.com.
⁷ Department of Surgery, Faculty of Medicine, Saga University, Japan. Electronic address: jueda@cc.saga-u.ac.jp.
⁸ Department of Radiology, Faculty of Medicine, Saga University, Japan. Electronic address: irie@cc.saga-u.ac.jp.
⁹ Department of Surgery, Faculty of Medicine, Saga University, Japan. Electronic address: noshiro@cc.saga-u.ac.jp.

Abstract

Introduction: A single gallbladder with a double cystic duct is a very rare finding. In addition, few cases with this rare condition are preoperatively diagnosed. However, the preoperative confirmation or suspicion of this rare condition could facilitate safe laparoscopic cholecystectomy, which is a minimally invasive therapeutic modality for gallbladder disease. We herein present a case of gallstone disease in a patient with a double cystic duct who was preoperatively diagnosed and successfully treated with laparoscopic cholecystectomy.

Presentation of case: A 57-year-old woman was admitted to our hospital with epigastric pain. Gallstone disease in the gallbladder and common bile duct was diagnosed by ultrasonography and computed tomography. Magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiography (ERC) revealed that the aberrant cystic duct arose from the cystic duct and communicated with the intrahepatic bile duct of the posterior segmental branch. Laparoscopic cholecystectomy was successfully performed in combination with intraoperative cholangiography.

Discussion: If an anomaly of the biliary duct system is not identified during surgery, it may turn out to be a bile leak. The preoperative diagnosis of a double cystic duct allows laparoscopic cholecystectomy to be performed safely in combination with intraoperative cholangiography.

Conclusions: A single gallbladder with double cystic duct is a very rare anomaly. However, laparoscopic surgery can be facilitated by the use of preoperative and intraoperative images.

Keywords: Double cystic duct; Duplication of cystic duct; Laparoscopic cholecystectomy.