AN ANOMALY OF THE EXTRAHEPATIC BILIARY SYSTEM

An anomaly of the extrahepatic biliary system is reported in which the common hepatic duct was found to enter the gallbladder, whereas the c ystic duct drained the whole biliary system into the duodenum. Review of the literature revealed only eight previously reported similar case s. To ascertain such anatomy, a choledochal cyst and the Mirizzi syndr ome must be excluded. In the past, the rarity of the configuration des cribed herein led to transection of the common hepatic duct during cho lecystectomy in most cases. The concomitant presence of other abdomina l anomalies, as in our case, or severe inflammation in the porta hepat is should prompt suspicion of biliary anomalous anatomy. In that case, dissection of the gall bladder from the fundus downward will allow ti mely discovery of such an anomaly. Maintenance of continuity between t he common hepatic duct and cystic-common biliary duct by preserving pa rt of the gallbladder permits easy repair on a T tube.