An Accessory Double Cystic Duct with a Single Gall Bladder

ABSTRACT

We report a rare case of a double cystic duct in a 55-year-old woman. The patient complained of upper abdominal pain and jaundice. The patient was diagnosed with distal common bile duct (CBD) cancer by endoscopic retrograde cholangiopancreatography (ERCP). ERCP was unable to reveal the presence of a double cystic duct. However, magnetic resonance imaging (MRI) and a percutaneous transhepatic biliary drainage (PTBD) were performed as images for obstructive jaundice before surgery showed two ducts that looked like cystic ducts-one duct branched from the common bile duct and the other duct branched from the right hepatic duct. A pancreatoduodenectomy was performed to remove the distal CBD cancer and the presence of a double cystic duct was confirmed with the naked eye. This case suggests that the imaging studies, such as preoperative ERCP and MRI or intraoperative cholangiography are required to avoid complications during hepatobiliary surgery.