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      A Double Cystic Duct With a Single Gallbladder Successfully Treated With Laparoscopic Cholecystectomy: A Challenge to Laparoscopic Surgeons

      case-report

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          Abstract

          Although the cystic duct has diverse variations, a double cystic duct is rarely found. Only 20 cases had been reported until late 2017. In the present study, we describe a 58-year-old woman with a double cystic duct who initially presented with a passed stone and pancreatitis concomitant with a gallbladder containing microlithiasis. The double cystic duct was not detected in preoperative endoscopic ultrasonography; and the anomaly was an incidental finding during laparoscopic cholecystectomy. The patient had no postoperative complications and was discharged uneventfully. Postoperative magnetic resonance cholangiography showed a normal biliary tree structure.

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          The accessory gall-bladder- an embryological and comparative study of aberrant biliary vesicles occurring in man and the domestic mammals

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            Anatomical Variations of Cystic Ducts in Magnetic Resonance Cholangiopancreatography and Clinical Implications

            Background. Anatomical variations of cystic duct (CD) are frequently unrecognized. It is important to be aware of these variations prior to any surgical, percutaneous, or endoscopic intervention procedures. Objectives. The purpose of our study was to demonstrate the imaging features of CD and its variants using magnetic resonance cholangiopancreatography (MRCP) and document their prevalence in our population. Materials and Methods. This study included 198 patients who underwent MRCP due to different indications. Images were evaluated in picture archiving communication system (PACS) and variations of CD were documented. Results. Normal lateral insertion of CD at middle third of common hepatic duct was seen in 51% of cases. Medial insertion was seen in 16% of cases, of which 4% were low medial insertions. Low insertion of CD was noted in 9% of cases. Parallel course of CD was present in 7.5% of cases. High insertion was noted in 6% and short CD in 1% of cases. In 1 case, CD was draining into right hepatic duct. Congenital cystic dilation of CD was noted in one case with evidence of type IV choledochal cyst. Conclusion. Cystic duct variations are common and MRCP is an optimal imaging modality for demonstration of cystic duct anatomy.
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              Double Cystic Duct in a Septated Gallbladder

              Double cystic duct in a single gallbladder is one of the least common variances encountered in the biliary system. This article presents a 54-year-old man who had a septated gallbladder with 2 separate cystic ducts. With intraoperative cholangiogram, he had successful laparoscopic cholecystectomy without any ductal injuries or complications.
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                Author and article information

                Journal
                Iran J Med Sci
                Iran J Med Sci
                Iranian Journal of Medical Sciences
                Shiraz University of Medical Sciences (Iran )
                0253-0716
                1735-3688
                September 2020
                : 45
                : 5
                : 391-394
                Affiliations
                [1 ] Department of General Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
                [2 ] Department of Internal Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
                [3 ] Department of General Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
                Author notes
                Corresponding author: Abdolhamid Chavoshi Khamneh, MD; Imam Khomeini Hospital Complex, Tohid Square, Postal code: 14197-33141, Tehran, Iran. Tel: +98 21 82141000, Fax: +98 21 88602217, Email: chavoshikhamneh.ah@ 123456gmail.com
                Article
                IJMS-45-5
                10.30476/ijms.2020.83304.1229
                7519403
                a2906723-2f4d-42b6-a746-88edf65de6ad
                Copyright: © Iranian Journal of Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 4.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 01 February 2020
                : 07 March 2020
                : 24 September 2019
                Categories
                Case Report

                Medicine
                bile ducts , gallbladder , cholangitis , gallstones , cystic duct
                Medicine
                bile ducts , gallbladder , cholangitis , gallstones , cystic duct

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