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CC BY 4.0 · Surg J (N Y) 2021; 07(03): e138-e141
DOI: 10.1055/s-0041-1731428
Case Report

Hepaticocystic Duct in an Era of Laparoscopic Cholecystectomy

Jignesh A. Gandhi
1   Department of General Surgery, Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
,
Pravin Shinde 
1   Department of General Surgery, Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
,
Sadashiv N. Chaudhari
1   Department of General Surgery, Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
,
Amay Banker
1   Department of General Surgery, Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Abstract

The biliary tract is notorious for its variable anatomy. A persistent hepaticocystic duct with agenesis of common bile duct is a rare biliary anomaly that creates a diagnostic dilemma and can add to the operative difficulties. It is important to diagnose this anomaly preoperatively since the gallbladder forms an integral part of bilioenteric continuity and an inadvertent cholecystectomy can lead to a surgical catastrophe. If diagnosed, surgeons can plan definitive treatment in the form of biliary diversion. We present a case of a 22-year-old man, who presented to us with obstructive jaundice and cholangitis. The biliary system was decompressed initially with a percutaneous transhepatic biliary drainage and an endoscopic retrograde cholangiogram established the diagnosis of a type IV hepaticocystic duct preoperatively in our case. Since diagnosis was made prior to operative intervention, we were able to perform a cholecystojejunostomy to maintain biliary continuity. The patient was discharged with an uneventful postoperative course. To our knowledge, this is the first report of such a variation being diagnosed preoperatively. We are also presenting a brief review of literature about persistent hepaticocystic ducts and the embryological basis of their origin.

Keywords

hepaticocystic duct - extrahepatic biliary tree - agenesis of common bile duct


Publication History

Received: 30 March 2020

Accepted: 31 March 2021

Article published online:
19 July 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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