Double cyst duct in a young woman with a history of systemic lupus: A case report

• Published in: International journal of surgery case reports Vol. 124; p. 110459
• Main Authors: Jiménez, Salvador Carlos, Velázquez, Miriam Natividad Jiménez, Nava, Juan Carlos Rivera, Torres, Raúl Alejandro Núñez, Hernández, Edgard Efrén Lozada, Ruiz, Jose Alaniz
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-11-2024; Elsevier
• Subjects: Bile duct; Case Report; Cholecystectomy; Cholecystitis; Choledocholithiasis; Double cystic; Cholecystectomy; Case report; Double cystic; Choledocholithiasis; Cholecystitis; Bile duct
• DOI: 10.1016/j.ijscr.2024.110459
• EISSN: 2210-2612

Cholecystectomy is the most common general surgery procedure, necessitating thorough knowledge of bile duct anatomy. Despite the bile duct's anatomical diversity, reports of double cystic ducts are rare. This case presentation aims to emphasize the importance of recognizing this unusual anatomical variant during surgical procedures to prevent complications and ensure patient safety.
This is a 22-year-old woman with a history of lupus. Initial clinical and ultrasound evaluations concluded she had cholangitis, choledocholithiasis, and cholecystitis.
A cholecystectomy was performed, during which a double cystic duct was identified and confirmed with intraoperative cholangiography.
Five days after surgery, the patient exhibited increased bilirubin levels, and a follow-up cholangiography showed dilation of the common bile duct with no passage of contrast medium into the duodenum. She underwent ERCP with endoprosthesis placement and is currently under follow-up with adequate progress.
Double cystic ducts are extremely rare anatomical variants. These variations pose significant challenges for surgeons during surgery, emphasizing the need for a universal culture of safety during cholecystectomy.
Although this anatomical variant is rare, surgeons must be aware of it. Given the uncertainty of anatomy, it is advisable to perform intraoperative imaging, such as cholangiography, before sectioning any duct.
Double cystic duct variations are rare, but when bile duct anatomy is unclear, intraoperative cholangiography is essential. This technique improves visualization of biliary structures, aiding informed decisions before duct ligation and reducing the risk of bile duct disruption.
•Cholecystectomy is the most common general surgery procedure•The bile duct is one of the most anatomically diverse structures•Anatomical variations of double cystic ducts are extremely rare