Incidental Discovery of Cholecystohepatic Duct during Laparoscopic Cholecystectomy: A Case Report and Literature Review

Abstract

Cholecystohepatic bile duct (CHD) is a rare anomaly of the biliary system. It is defined as a network of bile ducts located in the perihepatic connective tissue of the gallbladder fossa connecting directly to the extrahepatic bile duct, cystic duct, or gallbladder. This aberrant duct can be responsible for the biliary drainage of a sector, segment, or limited area of the liver. We report the case of type III accessory subvesical bile duct that was detected incidentally during laparoscopic cholecystectomy. Intraoperative cholangiogram confirmed an aberrant and dispensable communication with the biliary tree that was clipped and transected. Patient experienced a transient subclinical hyperbilirubinemia that was resolved spontaneously without any sequelae. CHD is an unusual surgical finding of clinical significance. Its injury can cause prolonged bile leakage or significant obstructive jaundice, causing a delay in post-operative recovery. We report this case to raise the awareness of this anatomic variation by highlighting the importance of intraoperative identification and instant cholangiography that aid in prompt decision making and hence avoidance of evitable complications.