Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
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Duplicated extrahepatic bile duct (type Vb): An important rare anomaly

  • Vaibhav Kumar Varshney (Department of Surgical Gastroenterology, All India Institute of Medical Sciences) ;
  • Sabir Hussain (Department of Gastroenterology, Dr. S N Medical College) ;
  • N. Vignesh (Department of Surgical Gastroenterology, All India Institute of Medical Sciences) ;
  • B. Selvakumar (Department of Surgical Gastroenterology, All India Institute of Medical Sciences) ;
  • Lokesh Agarwal (Department of Surgical Gastroenterology, All India Institute of Medical Sciences) ;
  • Taruna Yadav (Department of Radiodiagnosis, All India Institute of Medical Sciences)
  • Received : 2022.11.22
  • Accepted : 2023.01.16
  • Published : 2023.05.31
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Abstract

Congenital duplication of the extrahepatic bile duct (DEBD) is an unusual anomaly of the biliary system. It occurs due to inability of the embryological duplex biliary system to regress. DEBD has various subtypes depending on the morphology and opening of the aberrant common bile duct. It can have distinct complications. We encountered a 38-year-old lady who experienced pain in the right upper abdomen along with a low-grade fever. Magnetic resonance cholangiopancreatography revealed DEBD with multiple calculi in the right hepatic duct (ductolithiasis) and joining of the right hepatic duct with the left hepatic duct in the intrapancreatic region. Endoscopic retrograde cholangiography failed to clear the calculi from the right duct. They were then managed by common bile duct exploration and roux-en-Y right hepaticojejunostomy for biliary drainage. Her postoperative period was uneventful. She is currently doing well after three months of follow-up. Hence, a proper preoperative delineation of such rare anomalies is essential. It could avoid inadvertent injury to the bile duct and operative complications.

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References

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