title: Gallbladder agenesis with a stone in the cystic duct bud.
abstract: An 84-year-old woman was admitted to the hospital because of pyloric stenosis caused by gastric cancer. Abdominal computed tomography and magnetic resonance imaging failed to demonstrate the gallbladder, but showed a gallstone in a duct-like structure parallel to the common bile duct. When laparotomy was performed, the gallbladder and the fossa were not observed, and a blind-end duct, similar to a cystic duct, was found beside the common bile duct. Incisional exploration of the common bile duct was done after distal gastrectomy; the gallstone was not found in the common bile duct, but in the duct parallel to it. By observing the duct beneath the common bile duct with a cholangioscope, we considered it to be a hypoplastic cystic duct. After the gallstone was removed, a T-tube was placed into the common bile duct. Agenesis of the gallbladder is a rare congenital anomaly and is often asymptomatic. As far as we know, this is the first report of gallbladder agenesis with a hypoplastic cystic duct impacted with a stone. Careful intraoperative examination using a cholangioscope is useful to confirm the structure of the common bile duct.
authors.affiliation: Department of Gastroenterological Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryocho, Aobaku, Sendai 980-8574, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ishida
authors.forename: Shinichi
authors.initials: S
authors.lastname: Egawa
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Masato
authors.initials: M
authors.lastname: Kohari
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohwada
authors.forename: Michiaki
authors.initials: M
authors.lastname: Unno
mesh_terms: D000369:Aged, 80 and over; D002769:Cholelithiasis / Q000601:surgery*; D003549:Cystic Duct / Q000002:abnormalities* / Q000601:surgery; D005260:Female; D005704:Gallbladder / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery*