Cholangioscopy to diagnose and treat a patient with congenital absence of the cystic duct

Abstract

A 15-year-old young woman presented with progressive painless jaundice that she had experienced for 6 weeks. Owing to failed biliary cannulation during the first ERCP attempt, temporary drainage from the left intrahepatic duct was provided before biliary access was successful. A cholangiogram revealed a normal-sized common bile duct (CBD) with abrupt dilatation of the common hepatic and intrahepatic ducts and marked dilatation of the gallbladder (A). Cholangioscopy revealed a mucosal ring at the gallbladder opening (B), and a guidewire was placed through the cholangioscope into the gallbladder.