Anomalous insertion of the right hepatic duct into the cystic duct: Reportof a case diagnosed before laparoscopic cholecystectomy

Although an aberrant hepatic duct entering the cystic duct is not especiall y rare, the main right hepatic duct entering the cystic duct is extremely r are, with only six cases reported thus far. All of the reported patients un derwent open cholecystectomy, during which one patient received a bile duct injury. The anomaly was unsuspected preoperatively in all of these cases. We report an additional patient with this anomaly, the first such case diag nosed before laparoscopic cholecystectomy using direct cholangiography. Cho langiography may be mandatory whenever biliary anomalies are suspected duri ng laparoscopic cholecystectomy. As the right hepatic duct entering the cys tic duct can lead to ductal injury, this anomaly should be kept in mind whe n performing laparoscopic cholecystectomy.