Gallbladder cancer spreading into the aberrant cystic duct: First literature report

Junji Iwasaki; Taku Iida; Keiji Nagata; Kojiro Nakamura; Atsushi Itami; Takahisa Kyogoku

doi:10.1016/j.ijscr.2021.106443

Gallbladder cancer spreading into the aberrant cystic duct: First literature report

Int J Surg Case Rep. 2021 Nov:88:106443. doi: 10.1016/j.ijscr.2021.106443. Epub 2021 Sep 30.

Authors

Junji Iwasaki¹, Taku Iida², Keiji Nagata³, Kojiro Nakamura⁴, Atsushi Itami⁵, Takahisa Kyogoku⁶

Affiliations

¹ Department of Surgery, Kobe City Nishi-Kobe Medical Center, Hyogo, Japan. Electronic address: junji.i@kuhp.kyoto-u.ac.jp.
² Department of Surgery, Kobe City Nishi-Kobe Medical Center, Hyogo, Japan. Electronic address: itaku9108@gmail.com.
³ Department of Surgery, Kobe City Nishi-Kobe Medical Center, Hyogo, Japan. Electronic address: kn10th@yahoo.co.jp.
⁴ Department of Surgery, Kobe City Nishi-Kobe Medical Center, Hyogo, Japan. Electronic address: kojiro@kuhp.kyoto-u.ac.jp.
⁵ Department of Surgery, Kobe City Nishi-Kobe Medical Center, Hyogo, Japan. Electronic address: atsushi_itami@kcho.jp.
⁶ Department of Surgery, Kobe City Nishi-Kobe Medical Center, Hyogo, Japan. Electronic address: takahisa_kyogoku@kcho.jp.

Abstract

Introduction and importance: Although variations from the standard anatomy of the extrahepatic bile ducts are common, duplication of the cystic duct draining a single gallbladder is an extremely rare variant. We herein describe the first report of gallbladder cancer spreading into the aberrant cystic duct.

Case presentation: A 60-year-old female presented with upper abdominal pain, and she was diagnosed with gallbladder cancer. Intraoperatively, she was found to have a duplicated cystic duct draining a single gallbladder, and her cancer had spread into the aberrant cystic duct entering the anterior right hepatic duct. Right hepatectomy with extrahepatic bile duct resection was performed to achieve R0 resection.

Clinical discussion: In the English literature, 28 cases of duplicated cystic duct draining a single gallbladder have been reported. However, no cases of gallbladder cancer have been described in these previous reports.

Conclusion: We report the first case of gallbladder cancer spreading into the aberrant cystic duct. To perform an oncologically adequate operation, exact assessment of the biliary tree is essential not only preoperatively but also intraoperatively.

Keywords: Case report; Duplicated cystic duct; Gallbladder cancer.