TWO CASES OF CHOLECYSTLITHIASIS WITH DOUBLE CYSTIC DUCT

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  • 重複胆嚢管を伴う胆嚢結石症の２例

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Abstract

“Double cystic duct” is a rare anomaly of the biliary duct system. Two cases of cholecystolithiasis with double cystic duct were encounted. The first patient was a 60-year-old woman in whom cholecystolithiasis was detected by abdominal ultrasonography at a medical check up. Laparoscopic cholecystectomy was performed in June 2004. Intraoperative cholangiography from the main cystic duct showed another cystic duct, which had diverged from the right hepatic duct. The second patient was a 46-year-old man who had recurrent bouts of right upper abdominal pain presumably due to cholecystolithiasis. Laparoscopic cholecystectomy was done in May 2006. Intraoperative cholangiography through the main cystic duct showed another cystic duct from the right hepatic duct. Double cystic duct was diagnosed. At surgery the gallbladder was removed after the both cystic ducts were transected.<BR>“Double cystic duct” is a rare unnatural run of the biliary duct system, and it can be a cause of intraoperative injury. It is difficult to detect this anomaly by conventional preoperative examinations. These cases suggest the importance of intraoperative cholangiography to avoid unexpected injury of the cystic duct during laparoscopic cholecystectomy. Clinical reports of double cystic duct have been accumulating, and we present the case, together with some bibliographical comments.

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