Choledochal cyst with an aberrant right cholecysto-hepatic duct draining into cystic duct and a review of literature

Cystic duct entering to right hepatic duct; a case report with literature review

“…Previous studies reported the prevalence of biliary duct anomalies as 12 %, with anomalous right hepatic duct emptying into the common hepatic or cystic duct as the most common one [11] . Although there are some reports about such aberrancies from the cystic duct to the right hepatic duct [2] , [3] , [5] , [6] , [7] , [8] , [9] , cystic duct into the left hepatic duct [12] , [13] , [14] , and even from the cystic duct to common hepatic duct [15] , [16] . It seems important evaluating the biliary duct preoperatively and intraoperatively of probable aberrant biliary duct variations for preventing bile duct injury.…”

“…Considering the common prevalence of anatomic variations in the biliary tree as mentioned in previous and newer studies [11] , [17] , cholecystectomy as the most prevalent surgery worldwide [18] , many case reports of different anomalies as mentioned above [2] , [3] , [5] , [6] , [7] , [8] , [9] , [12] , [13] , [14] , [15] , [16] , variations of the cystic duct as the most important form of anomalies from the surgical point of view [19] , elective nature of surgery or endoscopic diagnostic/therapeutic interventions in most cases of biliary tree diseases [20] , and preventable disasters without knowing the anatomy of the biliary tree, it may be the time to reinforce radiologic evaluations like MRCP, CT scan, ERCP or sonography before such interventions before or during the surgery/endoscopic interventions.…”

“…Our literature review of similar cases showed both young and old involved patients, either black or white, with no preference in sex, with different clinical presentations like abdominal pain, fever, and/or jaundice and different accompanying symptoms and signs suspicious to pancreatitis, evidence of gall stones, with different laboratory findings like elevated serum amylase, evidence of cholestasis, either preoperatively or intraoperatively or both and with different diagnostic tools like sonography, CT scan, ERCP or MRCP [2] , [3] , [5] , [6] , [7] , [8] , [9] .…”

“…This case study is reported in line with SCARE guidelines [1] . Knowledge about any anatomical variation in bile duct helps surgeons and endoscopists to decrease the chance of iatrogenic complication during the procedure [2] . Surgeons may mistakenly consider the right hepatic duct as cystic duct, ligate, and divide it [3] .…”

Robotic Choledocal Cyst Resection and Hepaticojejunostomy at a Case with Aberrant Hepatic Artery Sailing on the Gall Bladder

“…Even the variations of abnormal biliary tract anatomy, such as biliary tract cysts, are the most challenging of the biliary tract variations. Hathiramani et al [9] and Mantas et al [10] presented cases with aberrant bile ducts draining into a choledocal cyst. Fortunately, our case did not have a biliary tract variation coinciding with hepatic artery variation and choledocal cyst.…”