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A Patient with a Left Accessory Hepatic Duct with Gallstones
Author(s) -
SAWABE Jun,
ISHIDA Hideaki,
NIIZAWA Makoto,
NAGANUMA Hiroko,
UNO Atsushi,
MASAMUNE Osamu
Publication year - 1994
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1994.tb00698.x
Subject(s) - medicine , left hepatic duct , cystic duct , common hepatic duct , anatomy , gallstones , gallbladder , biliary tract , radiology , cholangiography , duct (anatomy) , common bile duct
Accessory hepatic ducts, especially the left ducts, are relatively rare anomalies of the biliary tract. We present here a patient with this anomaly complicated by the presence of multiple stones. Endoscopic retrograde cholangiography (ERC) and ultrasound (US) were very useful in establishing the diagnosis preoperatively and in determining our surgical strategy. ERC demonstrated the left accessory hepatic duct with multiple radiolucent stones at the level of the cystic duct on the opposite side of the gallbladder. US demonstrated a hyperechoic mass measuring 15×10 mm with an acoustic shadow at the hepatic hilus. It also showed the internal “honey‐comb” structure of the mass which contained numerous stones measuring 5–6 mm in diameter and a fine tubular structure between the accessory hepatic duct and the caudate lobe. Intraoperatively the sac‐like, dilated (35×10 mm), left accessory hepatic duct was filled with numerous bilirubin stones originating at the cystic duct from its contralateral side. A few fine bile ducts communicated with the accessory hepatic duct and the caudate lobe.