A case of a rare biliary anomaly similar to double common hepatic ducts

Abstract

We report a patient with a rare biliary anomaly incidentally diagnosed during preoperative evaluation for gallbladder tumor. Balloon-occluded cholangiography was helpful in the diagnosis of this abnormality. A 55-year-old woman complaining of epigastralgia was admitted to our hospital for evaluation of gallbladder tumor. Endoscopic retrograde cholangio-pancreatography showed a p-type pancreatobiliary maljunction. Cholangiography, performed with an inflated balloon catheter, demonstrated ring-shaped hepatic ducts from which the intrahepatic biliary blanches emerged. The cystic duct was branching below the hepatic duct confluence. Palliative enteric by-pass surgery was performed because of advanced gallbladder cancer.