Two Cases of Cholelithiasis with an Aberrant Hepatic Duct Joining the Gallbladder that were Diagnosed Preoperatively

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  • Kurata Masanao
    Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
  • Honda Goro
    Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
  • Okuda Yukihiro
    Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
  • Tadano Sosuke
    Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
  • Tsuruta Koji
    Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital

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Other Title
  • 術前に胆嚢管および胆嚢に合流する副肝管を診断した胆石症の2例

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Case 1: A 62-year-old woman was given a diagnosis of common bile duct stone. Magnetic resonance cholangiopancreatography (MRCP) showed the aberrant posterior hepatic duct joining the cystic duct. After endoscopic choledocolithotomy, we performed laparoscopic cholecystectomy (LC), preserving the aberrant posterior hepatic duct. On MRCP after the LC one month later, there was no stenosis of the posterior hepatic duct or remnant cystic duct. Case 2: A 63-year-old woman was admitted for fever and icterus. Acute cholangitis was diagnosed. Direct cholangiography using endoscopic nasobiliary drainage tube revealed that the aberrant posterior hepatic duct joined the infundibulum of the gallbladder, and a calculus was present in the cystic duct. We conducted open cholecystectomy with reconstruction of the posterior hepatic duct. Discussion: An aberrant hepatic duct can be detected by paying attention to the infraportal posterior hepatic duct, because most of the aberrant hepatic ducts joining the gallbladder are infraportal posterior hepatic ducts. In this type of joining with the cystic duct, LC can be performed safely by appropriate manual skill; however, depending on the type of joining with the infundibulum, body or fundus of the gallbladder, the reconstruction of the post hepatic duct should be performed after whole gallbladder resection.

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