title: An unexpected surprise at the end of a "quiet" cholecystectomy. A case report and review of the literature.
abstract: BACKGROUND
  Anatomic unexpected variations in biliary tree may be discovered during laparoscopic cholecystectomy.
  
  
  METHODS
  A 57-year-old man was admitted for abdominal pain, vomiting and mild jaundice. Abdominal ultrasonography revealed a gallbladder containing multiple stones and biliary sludge. All pre-operative investigations showed no anatomical variations in extrahepatic biliary tree. During surgical intervention an accessory extrahepatic duct, connecting the IV segment of the liver to the fundus of gallbladder, was discovered.
  
  
  CONCLUSIONS
  Pre-operative routine investigations for gall stones diseases may not reveal anatomic variations of biliary tree.
authors.affiliation: Unità Operativa di Chirurgia d'Urgenza, ARNAS Civico, Palermo, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Fazio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Damiano
authors.forename: Vincenzo Davide
authors.initials: VD
authors.lastname: Palumbo
authors.forename: Gabriele
authors.initials: G
authors.lastname: Spinelli
authors.forename: Antonio
authors.initials: A
authors.lastname: Scio
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tomasello
authors.forename: Antonio
authors.initials: A
authors.lastname: Marrazzo
authors.forename: Salvatore
authors.initials: S
authors.lastname: Buscemi
authors.forename: Attilio Ignazio
authors.initials: AI
authors.lastname: Lo Monte
mesh_terms: D002763:Cholecystectomy; D006801:Humans; D008297:Male; D008875:Middle Aged