Hepato-Biliary-Pancreatic Surgery in patients with Communicating Accessory Bile Duct: Four Case report and literature review

Abstract

Case 1 and 2 underwent cholecystectomy for gallbladder stone, and case 3 and 4 underwent pancreatoduodenectomy for pancreatic head cancer. All cases had type F2 communicating accessory bile ducts (CABD) based on the Goor classification. CABD was diagnosed preoperatively in three cases, and intraoperatively in one case. In cholecystectomy cases, CABD was preserved to maintain the bile drainage. However, CABD was sacrificed in pancreatic cancer cases because of lymph node dissection. None of the patients developed postoperative biliary complications. In 26 cases that have been reported in Japan, 17 cases (65.4%) were diagnosed preoperatively. CABD were preserved in the most of the cases in cholecystectomy. CABD should be diagnosed preoperatively because CABD injury has high risk of bile leakage and stenosis. Intraoperative careful treatment for avoiding bile duct injury was crucial whether CABD was preserved or not.