A case report of double cystic duct during laparoscopic cholecystectomy in patient with chronic calcular cholecystitis

INTRODUCTION: Abnormal anatomy of the biliary tree predisposes patients to higher risks of ductal injury and postoperative complications. One of the extremely rare abnormalities of the cystic duct is the duplication of the cystic duct with a single gallbladder. The diagnosis is usually established during surgery. we report a case of double cystic duct with literature review. PRESENTATION OF CASE: A forty-two years old female patient who complained of recurrent biliary colic 9 months prior to the presentation. Murphy’s sigh was negative and with no other relevant clinical signs. DIAGNOSIS AND THERAPEUTIC INTERVENTION: Abdominal ultrasound showed multiple gall stones; the largest one was about 11 mm in diameter. Laparoscopic cholecystectomy was done under general anesthesia with 4 ports insertion. A double cystic duct accidentally encountered after clipping and cutting what was apparently a single cystic duct. Intraoperative cholangiogram was done to confirm the anomaly and exclude CBD injury. CONCLUSION: Double cystic duct is a very rare variant of the cystic duct anomaly. Proper knowledge of this anomaly should be kept in mind to avoid any unnecessary steps.