A Case of Congenital Choledochal Cyst With an Aberrant Right Hepatic Artery Arising From Gastroduodenal Artery

Abstract

We performed the excision of the entire extrahepatic duct and the gallbladder with hepaticojejunostomy for congenital choledochal cyst with an aberrant right hepatic artery (ARHA), which was a unique right hepatic artery arising from the gastroduodenal artery. Our patient was a two-year-old boy presenting with abdominal pain and postprandial vomiting. He was admitted because an abdominal ultrasound scan revealed acute cholecystitis. Contrast-enhanced computed tomography (CT) showed congenital choledochal cyst (type IV-A) with an ARHA, the accessory right hepatic artery, arising from the gastroduodenal artery and passing through the front of the dilated bile duct. The elective excision of the entire extrahepatic duct and the gallbladder with hepaticojejunostomy was performed and the ARHA was preserved successfully. His postoperative course was uneventful and he was discharged seven days after the surgery. The preoperative evaluation of vascular transit and careful surgical maneuvering enable the preservation of the ARHA.