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Review
. 2018 Feb;97(8):e9953.
doi: 10.1097/MD.0000000000009953.

Duplication of the extrahepatic bile duct: A case report and review of the literatures

Xiaoxiao Fan  1 , Lifeng He, P Asutosh Khadaroo, Daizhan Zhou, Hui Lin
Affiliations
Review

Duplication of the extrahepatic bile duct: A case report and review of the literatures

Xiaoxiao Fan et al. Medicine (Baltimore). 2018 Feb.

Abstract

Rationale: Duplication of the extrahepatic bile duct is an extremely rare congenital anomaly of the biliary system.

Patient concerns: A 44-year-old woman presented with a history of continuous upper abdominal pain and vomiting.

Diagnoses: Magnetic resonance cholangiopancreatography (MRCP) disclosed diffuse dilatation of the intrahepatic and extrahepatic bile ducts. Endoscopic retrograde cholangiopancreatography (ERCP) showed the presence of two extrahepatic bile ducts with calculus at the distal end of the CBD.

Interventions: Laparoscopic cholecystectomy (LC) was performed after an ERCP. Choledochoscopy, performed during the operation, showed duplicated common bile duct and the cystic duct was seen opening at the right side of the extrahepatic duct.

Outcomes: The patient was doing well after 6 months of follow-up.

Lessons: We reported a case of a double common duct with choledocholithiasis and gallstone. This rare anomaly may lead to cholangitis, common bile duct injury during surgery, malignancy occurrence, and should be treated with extreme care.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Magnetic resonance cholangiopancreatography showed common bile duct (A); double common bile duct was observed during the ERCP (B); diagram of the DCBD based on the intraoperative choledochoscopy (C). DCBD = double common bile duct, ERCP = endoscopic retrograde cholangiopancreatography.
Figure 2
Figure 2
Modified double common bile duct classification. Type I, a septum within the CBD lumen; Type II, the distal bile duct bifurcates and each channel independently drains into the different sites (stomach, pancreas, and duodenum); Type III, duplicated extrahepatic bile ducts with (type IIIa) or without (type IIIb) intrahepatic communicating duct; Type IV, duplicated extrahepatic bile ducts with extrahepatic communicating channel or both intrahepatic and extrahepatic communicating channels; Type V, duplicated extrahepatic bile ducts join as a single duct and drain into the duodenum.
See this image and copyright information in PMC

References

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    1. Choi E, Byun JH, Park BJ, et al. Duplication of the extrahepatic bile duct with anomalous union of the pancreaticobiliary ductal system revealed by MR cholangiopancreatography. Br J Radiol 2007;80:e150–4. - PubMed
    1. Arora A, Sureka B, Kasana V, et al. Common bile duct duplication: the more the murkier. Saudi J Gastroenterol 2015;21:51–4. - PMC - PubMed
    1. Chen G, Wang H, Zhang L, et al. Double common bile duct with choledochal cyst and cholelithiasis: report of a case. Surg Today 2014;44:778–82. - PubMed

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