Multiple Separated Cystic Ducts from a Single Common Bile Duct and One Gallbladder, New and Enormously Exceptional Variant in Literature: A Case Report

Abstract

This case report based on following the SCARE (Surgical Case Report) guiding principle. Construction and dissimilarities of the biliary tracts can pose greater threats of ductal damage and post-surgery complications for patients and surgeons. In the literature, we cannot find a similar case; in surgery, you find multiple separate cystic ducts.

This very exceptional case is a 28-year-old woman with chronic cholecystitis signs and symptoms, for which ultrasonography was normal, showing a gallstone. In surgery, we find multiple separated cystic ducts from a single gallbladder, with the insertion of the common bile duct (CBD). We ligate the main cystic ducts and multiple separated cystic ducts from a single gallbladder one by one, and avoided damage to the CBD. After her recovery, we discharge her healthy with no evidence of CBD damage.

Prior to any procedure for the recognition of these variations, we must ensure that we are familiar with the biliary anatomy through a suitable and acceptable method of examination. Detection is so vital to prevent ductal injury in the biliary tract. It is reasonable for physicians to use assessments such as MRCP (Magnetic resonance cholangiopancreatography), CT scan (computed tomography scan), ERCP (Endoscopic retrograde cholangiopancreatography), or sonography in advance, at a minimum, for patients with related signs or symptoms. In surgery parts, every surgeons should be alert about variations in biliary tract to protect patients in future damages and complications.

To address these concerns, certain procedures are needed. In the situation of laparoscopic cholecystectomy, it is vital to pay attention to many uncommon hereditary structures for any physician.