A CASE OF CHOLECYSTOLITHIASIS AND CHOLEDOCHOLITHIASIS WITH AN ACCESSORY CYSTIC DUCT

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  • 重複胆嚢管 (accessory cystic duct) のみられた胆嚢・胆管結石症の1例

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Abstract

It has been said that congenital morphological abnormalities of the biliary duct can be seen in a relatively large number of cases, however, accesorry cystic duct in which there are two cystic ducts is rarely encountered. Our experience with accessorry cystic duct in a patient with cholecystolithiasis and choledocholithiasis is described here.<br> A 79-year-old man had a right upper abdominal pain in May and was admitted to the hospital with a diagnosis of cholecystolithiasis and choledocholithiasis in July 1993, when he was operated on under general anesthesia. During surgery the cystic duct 3mm in diameter which started from the neck of the gallbladder ran to both the liver side and duodenal side forming a T-shape. Cholecystography after cholecystectomy visualized that one cystic duct running upwards met with the right hepatic duct and another cystic duct running downwards met with the common bile duct. Both cystic ducts wer exposed, and then ligated and excised in the vicinity of the confluence at the right hepatic duct and the confluence at the common bile duct, respectively. For the treatment of choledocholithiasis T-tube indwelling was performed after choledocotomy with lithotomy. With this case was have to reconfirm the importance that operative procedures should be proceeded by entertaining a probable abnormality of the biliary duct.

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