Abstract
It is known that biliary system branching shows various morphological abnormalities including accessory communicating bile duct. In this study, we report 2 patients with an accessory bile duct communicating between the right hepatic duct and the cystic duct. Patient 1 was a 68-year-old female. Patient 2 was a 63-year-old male. The two patients were referred and admitted to our hospital for obstructive jaundice. Detailed cholangiography prior to PTBD revealed the presence of an accessory bile duct communicating between the right hepatic duct and the cystic duct.
Pancreatoduodenectomy was performed under diagnoses of advanced cholangiocarcinoma and pancreatic head cancer in Patients 1 and 2, respectively. In these patients, the accessory communicating bile ducts did not have any single dominant region in the liver, and there was no stenosis affecting bile outflow in the right hepatic duct. Therefore, ligation was performed to treat the accessory communicating bile ducts. These abnormalities in the present cases were detected on direct cholangiography. However, such abnormalities have been increasingly detected on MRCP or DIC-CT. In the future, the widespread use and development of these procedures may facilitate the noninvasive evaluation of abnormalities in the biliary course without direct cholangiography.
