A case of an anomalous biliary tract diagnosed preoperatively

Abstract

We describe a 48-year-old man with cholecystolithiasis whose preoperative magnetic resonance cholangiopancreatography (MRCP) scan showed that the right accessory hepatic duct branching from the cystic duct dominated an anterior segment of the right hepatic lobe. We observed the right accessory hepatic duct using intraoperative cholangiography, and we were able to perform laparoscopic cholecystectomy without injuring it. He had no complication after discharge, and a drip-infusion cholangiography-computed tomography (DIC-CT) scan demonstrated that the right accessory hepatic duct was intact, and it dominated an anterior segment of the right hepatic lobe. During laparoscopic cholecystectomy, a bile duct injury is the most challenging perioperative complication. We selected MRCP preoperatively; however, if it is necessary for us to observe an anomalous biliary tract more precisely, we recommend selecting DIC-CT endoscopic retrograde cholangiopancreatography. Additionally, we think a bile duct injury can be avoided with intraoperative cholangiography, even if there is an anomalous biliary tract.