Define before you divide: surgical lessons from cystic duct insertion into the right hepatic duct

Sze Mun Thor; Xin Yi Goai; Georgi D. Atanasov

doi:10.18203/2349-2902.isj20260357

Authors

Sze Mun Thor Department of General Surgery, Goulburn Valley Health, Shepparton, Victoria, Australia
Xin Yi Goai Department of General Surgery, Goulburn Valley Health, Shepparton, Victoria, Australia
Georgi D. Atanasov Department of General Surgery, Goulburn Valley Health, Shepparton, Victoria, Australia

DOI:

https://doi.org/10.18203/2349-2902.isj20260357

Keywords:

Cystic duct anomaly, Aberrant biliary anatomy, Cholecystectomy, Bile duct injury

Abstract

Anatomical variations of the cystic duct are uncommon but clinically significant, as unrecognized variants increase the risk of catastrophic bile duct injury during cholecystectomy. We report a case of a 47-year-old woman presenting with biliary colic and transient cholestatic liver enzyme derangement, in whom an aberrant cystic duct draining directly into the right hepatic duct (RHD) was identified intraoperatively during cholangiography. The case highlights operative decision-making and reviews the role of dedicated preoperative imaging in detecting biliary duct anomalies to optimize surgical planning.

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