Accessory hepatic duct associated with a choledochal cyst

Abstract

This case report describes an accessory hepatic duct (AHD) identified by intraoperative cholangiography during excisional surgery of a choledochal cyst (CC). The accessory duct was divided and reconstructed successfully to the Roux-en-Y jejunal loop. The postoperative course was uneventful, and follow-up abdominal sonography revealed neither evidence of biliary tract obstruction nor atrophic changes of the liver. It is advocated that an AHD should be meticulously reconstructed if it is divided during excisional surgery of a CC.

EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones

“…No general recommendation can be given for the pharmacological prevention of recurrent bile duct stones (very low quality evidence; weak recommendation) Comment: Recurrent bile duct stones are observed in 5-20% of patients after endoscopic sphincterotomy [206][207][208][209][210][211] and can usually be removed endoscopically. Currently, there are no validated prophylactic measures.…”

Choledochal cyst associated with an accessory hepatic duct identified by intra-operative endoscopy: case report and literature review

“…To the best of our knowledge, there are only five other cases of CC associated with AHD in the literature (Table 1) [5][6][7]. Including our case, there are 2 boys and 4 girls.…”

Biliary ductal and vascular anomalies associated with choledochal cyst

“…[6], [7] Caution to identify the presence of anomalous arterial supply cannot be overemphasized, since it is the only way to avoid injury or accidental ligation -both of which can result in a major surgical disaster. The aberrant artery running in front of the common hepatic duct can be easily displaced behind the jejunal loop at the time of reconstruction.…”