2021 Volume 57 Issue 3 Pages 618-624
The patient was a 12-year-old female who presented with abdominal pain. She was referred to our hospital with diagnoses of congenital biliary dilation and acute pancreatitis. MRCP revealed double common bile ducts. The dilated common bile duct bifurcated into the right and left hepatic ducts and joined the main pancreatic duct. Another nondilated extrahepatic bile duct was found, bifurcating into the cystic duct and opening to the major duodenal papilla. ERCP revealed that two extrahepatic bile ducts were communicating immediately below the confluence of the left and right hepatic ducts, and the dilated extrahepatic bile duct joined the pancreatic duct to form a long common duct. The patient was diagnosed as having double common bile duct with pancreaticobiliary maljunction, and resection of extrahepatic bile ducts, including the accessary common bile duct, and hepatojejunostomy were performed. The proximal extrahepatic bile duct was dissected immediately below the confluence of the right and left hepatic ducts, and the distal bile extrahepatic ducts could be separated into two extrahepatic bile ducts and dissected at the intrapancreatic level. The double common bile duct is an extremely rare biliary malformation with only 97 cases, and only 11 pediatric cases, were reported in Japan. The high incidence of pancreaticobiliary maljunctinon in children is clinically important, and a malignant tumor developed in some adult patients. Complicated bile duct conditions may cause various comorbidities. Therefore, it is important to sufficiently and accurately evaluate the bile duct system and comorbidities, and to plan an appropriate treatment strategy.
