Double common bile duct with choledochal cyst and cholelithiasis: report of a case

Abstract

Double common bile duct (DCBD) is a rare congenital anomaly of the biliary system, often associated with biliary lithiasis, choledochal cyst, pancreaticobiliary maljunction (PBM), and upper gastrointestinal tract malignancies. We report a case of type I DCBD with choledochal cyst and cholelithiasis in a 52-year-old Chinese man. We also reviewed 24 cases of DCBD reported in the Chinese literature between 1965 and 2012. Most (58.3%) of these cases were classified as type I DCBD, with accompanying choledocholithiasis in 79.2%, cholecystolithiasis in 37.5%, choledochal cyst in 33.3%, and PBM in 8.3%. There was no case of concomitant cancer. The type and coexistence of PBM with DCBD are clinically important because of its close implications with concomitant pathology. Most Chinese people with DCBD have type I. Moreover, the high incidences of choledochal cyst and biliary lithiasis and the extremely low incidences of PBM and biliary cancer are the major clinical characteristics of DCBD in China.

Anatomical variations of liver blood supply in patients with pancreaticobiliary maljunction

“…Several authors have reported cases of annular pancreas (AP), pancreas divisum (PD), and double common bile duct (DCBD) accompanied by PBM [34][35][36][37][38][39]. Our cohort included one patient with PBM and PD together without vascular variants.…”

Duplicated common bile duct: a recipe for biliary injury. Report of a new variant

“…[9] reported an incidence of 48% calculous formation associated with DCBD anomaly. Review of 24 cases in the Chinese literature also revealed cholelithiasis in 37%, choledocholithiasis in 79%, choledochal cyst in 33% and PBM in 8% of the reported cases [10]. The high incidence of gallstone formation associated with this anomaly is thought be due to bile stasis and repetitive cholangitis resulting from reflux of gastrointestinal content into the anomalous duct.…”

Common bile duct duplication: The more the murkier

“…reviewed 24 cases from Chinese literature. [ 3 ] The greater incidence of the cases in this region might be related to the ethnicity. Yamashita et al .…”

“…Since this is an incomplete duplication, there is a consensus that the disruptive event that results in this variant may have occurred at a later phase of embryogenesis. [ 3 ] Only two cases of type Va DCBD have been reported in the literature to our knowledge. [ 13 ] Our case is the third reported of this least common variety.…”

“…[ 2 ] This intriguing anomaly has been reported in association with anomalous biliopancreatic junction, congenital choledochal cysts, and biliary atresia and can predispose to complications such as choledocholithiasis, cholangitis, pancreatitis, and malignancies, including cholangiocarcinoma and cancer of the upper gastrointestinal tract. [ 1 2 3 4 5 ]…”