title: Anomalous connection of the right hepatic duct into the cystic duct: utility of magnetic resonance cholangiopancreatography.
abstract: A 41-year-old female was admitted to our hospital for treatment of uterus carcinoma. Abdominal ultrasound showed gallbladder stones. Although magnetic resonance cholangiopancreatography revealed the right intrahepatic bile ducts, left hepatic duct and the common bile duct, the confluence of the right and left hepatic ducts was not visualized. At surgery, intra-operative cholangiography showed a biliary anomaly of the right hepatic duct entering the cystic duct. Subsequently cholecystectomy was accomplished without any injury to the bile duct. Our case may be the eighth such case of this rare biliary anomaly. When magnetic resonance cholangiopancreatography does not show the confluence of the right and left hepatic ducts, biliary anomaly of the right hepatic duct should be suspected and careful dissection should be performed from the Hartman's pouch, followed by intraoperative cholangiography, in order to avoid unnecessary injury to the bile duct.
authors.affiliation: Second Department of Surgery, Dokkyo University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan. satoshi@dokkyomed.ac.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sakuma
authors.forename: Kyu
authors.initials: K
authors.lastname: Rokkaku
authors.forename: Takehiko
authors.initials: T
authors.lastname: Nemoto
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kubota
mesh_terms: D000328:Adult; D002758:Cholangiography; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000175:diagnosis / Q000601:surgery; D003549:Cystic Duct / Q000002:abnormalities* / Q000473:pathology; D005260:Female; D006500:Hepatic Duct, Common / Q000002:abnormalities* / Q000473:pathology; D006801:Humans; D007044:Hysterectomy; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000601:surgery