Hepaticocystic duct: A rare anomaly of the extrahepatic biliary system

Interposition of Gallbladder - a Rare Extrahepatic Biliary Anomaly

“…Aberrant anatomy has been reported in upto 17% of cases with bile duct injury [1]. The biliary anatomy described in our case is extremely rare with few published reports in literature [2][3][4][5][6][7][8][9]. The anomaly has been described as 'interposition of gall bladder', 'hepaticocystic duct' and also by some as 'cholecystohepatic duct' [3][4][5][6][7].…”

“…The biliary anatomy described in our case is extremely rare with few published reports in literature [2][3][4][5][6][7][8][9]. The anomaly has been described as 'interposition of gall bladder', 'hepaticocystic duct' and also by some as 'cholecystohepatic duct' [3][4][5][6][7]. The term 'hepaticocystic' is preferred to 'cholecystohepatic' ducts as direction of flow of bile is from the hepatic ducts into the cystic duct [7] which provides the sole route of drainage of bile into duodenum.…”

“…The term 'hepaticocystic' is preferred to 'cholecystohepatic' ducts as direction of flow of bile is from the hepatic ducts into the cystic duct [7] which provides the sole route of drainage of bile into duodenum. Losanoff et al described four variants, type I in which right and left ducts open separately into gallbladder, type II where the ducts join upon entering gallbladder and type III seen in our case where the common hepatic ducts opens into the gallbladder [7]. Losanoff further subdivided Type III into four types based on entry of CHD into the gall bladder wall.…”

“…The anomaly has been described as 'interposition of gall bladder', 'hepaticocystic duct' and also by some as 'cholecystohepatic duct' [3][4][5][6][7]. The term 'hepaticocystic' is preferred to 'cholecystohepatic' ducts as direction of flow of bile is from the hepatic ducts into the cystic duct [7] which provides the sole route of drainage of bile into duodenum. Losanoff et al described four variants, type I in which right and left ducts open separately into gallbladder, type II where the ducts join upon entering gallbladder and type III seen in our case where the common hepatic ducts opens into the gallbladder [7].…”

Anatomical variations of the cystic duct: Two case reports

“…The rate of injury varies in the medical literature from 0% to 1% [5] . The following are some of the cystic duct variations found: (1) the cystic and common hepatic duct are in parallel; (2) low confluence of the cystic duct [2] ; (3) insertion of the cystic duct in the left and right hepatic ducts, and bifurcation of the left and right hepatic ducts [2] ; (4) anterior, posterior spiral types of insertion of the cystic duct on the left side of the common hepatic duct; (5) parahepatic duct insertion into the cystic duct; (6) absent or short cystic duct (length < 5 mm); (7) cystic duct hypertrophy, with a diameter > 5 mm; (8) double cystic duct [6,7] ; (9) right hepatic duct emptying into the cystic duct [8] ; and (10) hepaticocystic duct [9] , a very rare congenital abnormality in which the common hepatic duct enters the gallbladder. The left, right, and common hepatic ducts are all defective, with the cystic duct draining the entire biliary system into the duodenum.…”