A case of stones in the gallbladder and common bile duct with communicating accessory bile duct

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 71; no. 8; pp. 2105 - 2109
• Main Authors: TANOUE, Kiyonori, MAEMURA, Kousei, MASUMITSU, Kouichirou, IKEE, Takamasa, UENO, Shinichi, NATSUGOE, Shoji
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2010
• Subjects: communicating accessory bile duct; laparoscopic cholecystectomy
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.71.2105

We report a case of stones in the gallbladder and common bile duct with communicating accessory bile duct (CABD). A 45-year-old woman was urgently admitted to our hospital for abdominal pain. She was diagnosed with stones in the gallbladder and common bile duct by ultrasound and computed tomography (CT) of the abdomen. The stone in the common bile duct was removed endoscopically. The abnormality of the bile duct was not detected by preoperative endoscopic retrograde pancreaticocholangiography (ERCP) and drip infusion cholangiography-CT (DIC-CT). Therefore, endoscopic surgery was performed. A part of the cystic duct that had many stones was connected to the hepatic hilus. Bile was observed after the removed of the stones by incision of the CABD. Intraoperative cholangiography revealed divergence of the CABD from the right posterior branch of the liver. CABD was ligated at the root. Diagnosis of CABD by means of preoperative imaging was difficult since CABD was filled with stones. In such cases, the presence of the CABD should be considered and confirmed by intraoperative cholangiography.