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双胆总管——一例罕见病例报告及文献综述

Double common bile duct - A rare case report and review of literature.

作者信息

Doan Tu Trong, Pham Duong The, Van Nguyen Cuong, Tran Thanh Tuan, Van Nguyen Hai

机构信息

Department of Abdominal Surgery 2, Vietnam National Cancer Hospital, Viet Nam.

Department of Abdominal Surgery 2, Vietnam National Cancer Hospital, Viet Nam.

出版信息

Int J Surg Case Rep. 2025 Aug;133:111519. doi: 10.1016/j.ijscr.2025.111519. Epub 2025 Jun 14.

Abstract

INTRODUCTION

Extrahepatic bile duct duplication is an extremely rare congenital anomaly. There are five different types of this malformation. Due to unusual anatomy, the bile duct can be damaged during surgery. We herein report a case of double common bile duct and review the literature about this uncommon anatomical variation.

CASE PRESENTATION

A 72-year-old female was diagnosed with hepatic flexure colon cancer cT4bN1M0. The tumor invaded the pancreatic head and D2 duodenum in abdomen CT-scan. She underwent an en-bloc extended right hemicolectomy with duodenopancreatectomy and lymph node dissection. During surgery, we discovered that the cystic duct did not open into the common bile duct and there two parallel extrahepatic bile ducts merging into a single duct before draining into the D2 duodenum.

DISCUSSION

Bile duct duplication is an extremely rare congenital variation and has only been reported in the literature as clinical cases. According to Choi, there were five types of these anomalies, our clinical case was classified as type V of this classification.

CONCLUSION

We presented a case of double common bile duct discovered incidentally during surgery. The surgeons need to carefully expose the extrahepatic biliary tract to avoid bile duct injury.

摘要

引言

肝外胆管重复是一种极其罕见的先天性异常。这种畸形有五种不同类型。由于解剖结构异常,手术过程中胆管可能会受损。我们在此报告一例双胆总管病例,并回顾有关这种罕见解剖变异的文献。

病例介绍

一名72岁女性被诊断为肝曲结肠癌cT4bN1M0。腹部CT扫描显示肿瘤侵犯胰头和十二指肠降部。她接受了包括十二指肠胰头切除术和淋巴结清扫术的整块扩大右半结肠切除术。手术过程中,我们发现胆囊管未汇入胆总管,有两条平行的肝外胆管在汇入十二指肠降部之前合并为一条胆管。

讨论

胆管重复是一种极其罕见的先天性变异,文献中仅作为临床病例报道。根据Choi的分类,这些异常有五种类型,我们的临床病例属于该分类的V型。

结论

我们报告了一例手术中偶然发现的双胆总管病例。外科医生需要仔细暴露肝外胆道,以避免胆管损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1133/12213094/37833693988f/gr1.jpg

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