A Case of Communicating Accessory Bile Duct

Abstract

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.