Cystic Duct Duplication: Report of a Case and Short Review of the Literature

Abstract

Duplication of the cystic duct draining a normal gallbladder represents an extremely rare abnormality, which predisposes to complications during biliary surgery. We report the case of a female patient with cystic duct duplication who was treated in our Department. A short review of the relevant literature is also presented. A 61-year-old female patient was admitted to our Department due to acute biliary pancreatitis. She underwent laparoscopic cholecystectomy, during which duplication of the cystic duct was encountered. The procedure was completed laparoscopically without the need to perform intraoperative cholangiography. Gross pathological examination of the specimen confirmed the presence of two lumens in the cystic duct. To the best of our knowledge there exist only twenty cases reported in literature so far. Three different types of cystic duct duplication (H, Y and trabecular) have been described, depending on the point of insertion of each cystic duct in the common hepatic duct. Provided that the surgeon is capable of safely dissecting the porta hepatis to delineate anatomy, intraoperative cholangiography or conversion may be avoided. In conclusion, any surgeon operating on the biliary tree should be familiar with the wide range of anatomic variations that are frequently encountered, in order to avoid related morbidity.