A Case of Communicating Accessory Bile Duct

Eiji Sakamoto, Hiroshi Hasegawa, Shunichiro Komatsu, Takashi Hiromatsu, Tomotake Tabata, Kiyotaka Kawai, Seiji Natsume, Taro Aoba, Tomonori Tsuchiya and Naoki Matsumoto

Department of Surgery, Nagoya Daini Red Cross Hospital

This paper presents a rare case of a communicating accessory bile duct associated with cancer of the papilla of Vater. A 72-year-old woman was admitted to our hospital because of obstructive jaundice. Percutaneous transhepatic biliary drainage was performed. Tube cholangiography revealed a low union of the hepatic ducts and an accessory bile duct connected the right and left hepatic ducts. The cystic duct inserted into the right hepatic duct. Pancreatoduodenectomy was performed. The right and left hepatic ducts were transected just under the cystic duct and anastomosed to the jejunum. We considered that this case had a communicating accessory bile duct as reported by Goor. In this case, the bile ducts formed a 'circuit' at the hepatic hilum. Because each part of the circuit had almost the same diameter, it was difficult to determine which part was the communicating accessory bile duct. We review reported cases which had the same anomaly, and detail the classification of this type of anomaly.

Key words
communicating accessory bile duct, interhepatic duct, duplication of bile duct

Reprint requests
Eiji Sakamoto Department of Surgery, Nagoya Daini Red Cross Hospital
2-9 Myoukenchou Syouwa-ku, Nagoya, 466-8650 JAPAN

Accepted
November 30, 2005

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