Report of Two Cases of Type Ⅴb of Double Common Bile Duct and Review of The Literature_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SUN Hai ,  ZHANG Fengshen , CHEN Yan , WU Guodong , Deng Xiaoming

Department of Hepatobiliary Surgery， The 324th Hospital of PLA， Chongqing 400020， China;

Corresponding author：

ZHANG Fengshen, Email: zfs-cq@sohu.com

Keywords：

Double common bile duct; Laparoscopic cholecystectomy; Iatrogenic injury; Anomalous pancre-aticobiliary ductal junction; Choledochal cyst

Video：

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Object 　To evaluate the significance of double common bile duct （DCBD） in hepatobiliary surgery.
Metheds 　The data of diagnosis and treatment of two patients with DCBD in our hospital between Jul. to Dec. 2010 were analyzed retrospective， and the related literatures were reviewed.
Results 　The right hepatic bile duct of DCBD due to mistaking it for cystic duct in 1 case was accidental injuried during laparoscopic cholecystectomy. Another example，
the DCBD was confirmed by intraoperative exploration and choledochoscopic examination， at the same time with chole-
dochal cyst， anomalous pancreaticobiliary ductal junction （APBDJ）， primary hepatolithus， and choledocholith， and then operation was performed. Two cases were typeⅤb of DCBD. A total of 32 English literatures were reviewed. Since the beginning of 1932 English literature had reported 100 cases of DCBD. The type Ⅱand typeⅢwere the most common type of DCBD， and the typeⅤonly 10 cases. There were 27 cases of DCBD in twenty-five Chinese articles from 1994 to 2012. The typeⅤwas the most common type of DCBD. The accessory common bile duct （ACBD） opening in the duod-enum， gastric， and pancreatic duct were the most common. The common complications included stone， APBDJ， choled-ochal cyst， tumor etc.
Conclusions 　DCBD is a very rare anatomic variation of extrahepatic bile duct， often accompanied by calculus of bile duct and common bile duct cyst， APBDJ， and other biliary anatomy abnormality， and potentially carci-nogenic potential. The existence of DCBD may increase the risk of iatrogenic bile duct injury and complexity of biliary operation. In view of this， this abnormality of extrahepatic duct should be paid with close attention during operation.

Citation： SUN Hai,ZHANG Fengshen,CHEN Yan,WU Guodong,Deng Xiaoming. Report of Two Cases of Type Ⅴb of Double Common Bile Duct and Review of The Literature. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(4): 432-437. doi: Copy

1.	Yamashita K， Oka Y， Urakami A. Double common bile duct：A case report and a review of the Japanese literature[J]. Surgery，.
2.	Ravaioli M， Ercolani G， Cescon M， et al. Double common bile duct：A pitfall during liver transplantation and cholecystectomy[J]. Surgery， 2011， 150(1)：139-140.
3.	Swartley WB， Weeder SD. Choledochus cyst with a double common bile duct[J]. Ann Surg， 1935， 101(3)：912-920.
4.	Weeder SD. Choledochus cyst with doule common bile duct：sequelae and complication[J]. Ann Surg， 1939， 110(1)：55-59.
5.	Kodama T， Iseki J， Murata N， et al. Duplication of common bile duct—a case Report[J]. Jpn J Surg， 1980， 10(1)：67-71.
6.	Telium D. Double common bile duct. Case report and review[J].Endoscopy， 1986， 18(4)：159-161.
7.	Kondo K， Yokoyama I， Yokoyama Y， et al. Two cases of gastric cancer-bearing double choledochus with ectopic drainage into the stomach[J]. Cancer， 1986， 57(1)：138-141.
8.	Kanematsu M， Imaeda T， eki M， et al. Accessory bile duct draininginto the stomach：Case report and review[J]. GastrointestRadiol， 1992， 17(1)：27-30.
9.	Horsmans Y， De Grez T， Lefebvre V， et al. Double common bile duct with ectopic drainage of the left lobe into the stomach. Case report and review of the literature[J]. Acta Gastroenterol Belg， 1996， 59(4)：256-257.
10.	Leung B， Lai P， Chan A， et al. A variant of an accessory commonbile duct[J]. Endoscopy， 2000， 32(9)：728-730.
11.	Yamataka A， Yanai T， Hosoda YA， et al. Case of biliary atresia with duplication of the common bile duct[J]. J Pediatr Surg， 2001， 36(3)：506-507.
12.	Bernard P， Borgne JL， Dupas B， et al. Double common bile duct with ectopic drainage into the stomach case report and review of the literature[J]. Surg Radiol Anat， 2001， 23(4)：269-272.
13.	Amano Y， Takahashi M， Oishi T， et al. MR cholangiopancreatography of double common bile duct with ectopic drainage into stomach[J]. J Comput Assist Tomogr， 2002， 26(1)：141-142.
14.	Balbinot RA， Gobbato A， Balbinot SS， et al. Double bile duct with ectopic drainage into stomach[J]. Gastrointest Endosc， 2004， 60(4)：661-662.
15.	Bender EA， Springhetti S， Shemisa K， et al. Left-sided gallbladder (sinistroposition) with duplication of the common bile duct[J]. JSLS， 2007， 11(1)：148-150.
16.	Djuranovic SP， Ugljesic MB， Nenad S， et al. Double common bile duct：A case report[J]. World J Gastroenterol， 2007， 13(27)：3770-3772.
17.	Martins PN， Benckert C， Schlieker WV， et al. Intraduodenal diverticulum associated with a double common bile duct causing recurrent pancreatitis and cholangitis：report of a case[J]. Surg Today， 2007， 37(4)：320-324.
18.	Kim SW， Park DH， Shin HC， et al. Duplication of the extrahepatic bile duct in association with choledocholithiasis as depicted by MDCT[J]. Korean J Radiol， 2008， 9(6)：550-554.
19.	Park MS， Kim BC， Kim T， et al. Double common bile duct：curved-planar reformatted computed tomography (CT) and gadobenate dimeglumine-enhanced MR cholangiography[J]. J Magn Reson Imaging， 2008， 27(1)：209-211.
20.	Chujo M， Okubo M， Okubo K， et al. Double common bile duct：report of a case[J]. Int Surg， 2009， 94(1)：23-26.
21.	Paraskevas G， Papaziogas B， Ioannidis O， et al. Double commonbile duct：a case report[J]. Acta Chir Belg， 2009， 109(4)：507-509.
22.	Lee JH， Lee KG， Song SY， et al. New type of double common bile duct[J]. ANZ J Surg， 2011， 81(3)：200-201.
23.	Komuro H， Ono K， Hoshino N， et al. Bile duct duplication as a cause of distal bowel gas in neonatal duodenal obstruction[J]. J Pediatr Surg， 2011， 46(12)：2301-2304.
24.	Kawakubo K， Isayama H， Sasahira N， et al. Double common bile duct visualized by SpyGlass cholangioscopy[J]. Endoscopy， 2012， 44(Suppl 2)：e136-e137.
25.	Gupta V， Chandra A. Duplication of the extrahepatic bile duct[J]. Congenit Anom (Kyoto)， 2012， 52(3)：176-178.
26.	Tahara K， Ishimaru Y， Fujino J， et al. Association of extrahepatic bile duct duplication with pancreaticobiliary maljunction and congenital biliary dilatation in children：a case report and literature review[J]. Surg Today， 2012 Jul 24. [Epub ahead of print].
27.	Boyden EA. The problem of the double ductus choledochus (an interpretation of an accessory bile duct found attached to the pars superior of the duodenum)[J]. Anatom Rec， 1932， 55(1)：71-93.
28.	Goor DA， Ebert PA. Anomalies of the biliary tract tree. Report of a repair of an accessory bile duct and review of the literature[J]. Arch Surg， 1972， 104(3)：302-309.
29.	Saito N， Nakano A， Arase M， et al. A case of duplication of the common bile duct with anomaly of the intrahepatic bile duct[J]. Nippon Geka Gakkai Zasshi， 1988， 89(8)：1296-1301.
30.	Choi E， Byun JH， Park BJ， et al. Duplication of the extrahepatic bile duct with nomalous union of the pancreaticobiliary ductalsystem revealed by MR cholangiopancreatography[J]. Br J Radiol，.
31.	Hashimoto M， Okuda C， Shida K， et al. Double hepatic duct associated with anomalous pancreatobiliary ductal junction[J]. Am J Surg， 2004， 187(3)：433.
32.	Turmezei T， Ramjas G， Kumaran M. Extrahepatic bile duct duplication with choledocholithiasis in an accessory left bile duct draining into the antrum of the stomach：A case report[J]. Eur J Radiol Extra， 2010， 75(1)：e21-e25.
33.	谢扬信，徐成君. 胆总管重复畸形并结石致急性梗阻性化脓性胆管炎1例报告[J]. 中国普外基础与临床杂志， 2000， 9(5)：307.
34.	梁宏. 先天性肝总管及胆总管缺失伴双胆管畸型1例报告[J]. 中国普外基础与临床杂志， 2000， 7(3)：204.
35.	杨熙章，黄艺. 先天性双胆总管畸形1例[J]. 医学髟像学杂志， 2004， 14(11)：911.
36.	张启林，吴强. 先天性双胆总管畸形1例[J]. 中国普通外科杂志， 1997， 6(4)：216.
37.	杨毅，袁通立，刘培. 腹腔镜胆囊切除术中罕见胆道变异1例[J]. 中国普通外科杂志， 2012， 21(4)：1040.
38.	黄庆宁. B超诊断左右肝管异位汇人胰腺管1例[J]. 中华医学研究杂志， 2003， 3(4)：372.
39.	张仕林，李明珍. 胆道下段双管畸形并肝管狭窄1例[J]. 黔南民族医专学报， 2002， 15(2)：66.
40.	邓靖. 胆总管胆囊管重复畸形1例[J]. 肝胆外科杂志， 1996， 4(3)：133.
41.	孙伟，黄成钰，何峰. 胆总管内壁部分倒袋畸形1例[J]. 浙江医学， 2002， 24(7)：443.
42.	茆怀海. 肝外胆道变异1例[J]. 中华临床解剖杂志， 1996， 14(1)：37.
43.	张群伟，朱建峰. 肝外胆道畸形一例[J]. 肝胆外科杂志， 1995， 7(4)：35.
44.	刘佐军，孙立新，刘勇. 双胆总管畸形1例[J]. 中国普通外科杂志， 2005， 14(5)：364.
45.	严继生，魏希亮，刘启武等. 双胆总管畸形2例报告[J]. 河北职工医学院学报， 2003， 20(3)：19.
46.	赵亚新，周斌，蒋平. 双胆总管畸形伴巨大多发结石一例[J]. 中华肝胆外科杂志， 2004， 10(9)：615.
47.	王锡麟，陆建清，殷伯琦等. 双胆总管畸形伴双侧结石一例[J]. 肝胆胰外科杂志， 1999， 11(1)：10.
48.	李忠友，戴宗晴. 双肝管畸形一例[J]. 临床外科杂志， 2000， 8(3)：171.
49.	胡伯良. 双重肝内外胆道畸形1例报告[J]. 中国实用外科杂志， 1994， 14(3)：163.
50.	汪礼俊. 先天性胆总管管腔膜状分隔畸形致结石一例报道[J]. 腹部外科， 2004， 17(1)：151.
51.	徐振华. 先天性胆总管畸形一例[J]. 内蒙古医学杂志， 1998， 30(2)：78.
52.	程良忠. 先天性胆总管内膈膜畸形1例[J]. 中国普通外科杂志， 2000， 9(2)：116.
53.	翁伟健. 先天性肝内外胆管重复畸形伴结石1例[J]. 局部手术学杂志， 1997， 63(5)：56.
54.	李耀辉，李国胜，袁鲁明. 先天性肝外双腔胆管畸形二例[J]. 肝胆胰外科杂志， 1997， 9(1)：2.
55.	张二勇. 左右肝管前后重叠畸形1例报告[J]. 现代诊断与治疗， 1996， 7(6)：361.
56.	张铭恩，周淮彬，马玉春，等. 先天性双胆总管双乳头畸形舍并结石1例[J]. 中国实用外科杂志， 1996年， 6(2)：119.
57.	杨捷，罗云，杨复元. 先天性肝总管、胆总管及胆囊缺失伴双胆管畸形1例[J]. 大理学院学报， 2006， 5(10)：92.
58.	， 131(6)：676-681.
59.	， 80(955)：e150-e154.

1. Yamashita K， Oka Y， Urakami A. Double common bile duct：A case report and a review of the Japanese literature[J]. Surgery，.
2. Ravaioli M， Ercolani G， Cescon M， et al. Double common bile duct：A pitfall during liver transplantation and cholecystectomy[J]. Surgery， 2011， 150(1)：139-140.
3. Swartley WB， Weeder SD. Choledochus cyst with a double common bile duct[J]. Ann Surg， 1935， 101(3)：912-920.
4. Weeder SD. Choledochus cyst with doule common bile duct：sequelae and complication[J]. Ann Surg， 1939， 110(1)：55-59.
5. Kodama T， Iseki J， Murata N， et al. Duplication of common bile duct—a case Report[J]. Jpn J Surg， 1980， 10(1)：67-71.
6. Telium D. Double common bile duct. Case report and review[J].Endoscopy， 1986， 18(4)：159-161.
7. Kondo K， Yokoyama I， Yokoyama Y， et al. Two cases of gastric cancer-bearing double choledochus with ectopic drainage into the stomach[J]. Cancer， 1986， 57(1)：138-141.
8. Kanematsu M， Imaeda T， eki M， et al. Accessory bile duct draininginto the stomach：Case report and review[J]. GastrointestRadiol， 1992， 17(1)：27-30.
9. Horsmans Y， De Grez T， Lefebvre V， et al. Double common bile duct with ectopic drainage of the left lobe into the stomach. Case report and review of the literature[J]. Acta Gastroenterol Belg， 1996， 59(4)：256-257.
10. Leung B， Lai P， Chan A， et al. A variant of an accessory commonbile duct[J]. Endoscopy， 2000， 32(9)：728-730.
11. Yamataka A， Yanai T， Hosoda YA， et al. Case of biliary atresia with duplication of the common bile duct[J]. J Pediatr Surg， 2001， 36(3)：506-507.
12. Bernard P， Borgne JL， Dupas B， et al. Double common bile duct with ectopic drainage into the stomach case report and review of the literature[J]. Surg Radiol Anat， 2001， 23(4)：269-272.
13. Amano Y， Takahashi M， Oishi T， et al. MR cholangiopancreatography of double common bile duct with ectopic drainage into stomach[J]. J Comput Assist Tomogr， 2002， 26(1)：141-142.
14. Balbinot RA， Gobbato A， Balbinot SS， et al. Double bile duct with ectopic drainage into stomach[J]. Gastrointest Endosc， 2004， 60(4)：661-662.
15. Bender EA， Springhetti S， Shemisa K， et al. Left-sided gallbladder (sinistroposition) with duplication of the common bile duct[J]. JSLS， 2007， 11(1)：148-150.
16. Djuranovic SP， Ugljesic MB， Nenad S， et al. Double common bile duct：A case report[J]. World J Gastroenterol， 2007， 13(27)：3770-3772.
17. Martins PN， Benckert C， Schlieker WV， et al. Intraduodenal diverticulum associated with a double common bile duct causing recurrent pancreatitis and cholangitis：report of a case[J]. Surg Today， 2007， 37(4)：320-324.
18. Kim SW， Park DH， Shin HC， et al. Duplication of the extrahepatic bile duct in association with choledocholithiasis as depicted by MDCT[J]. Korean J Radiol， 2008， 9(6)：550-554.
19. Park MS， Kim BC， Kim T， et al. Double common bile duct：curved-planar reformatted computed tomography (CT) and gadobenate dimeglumine-enhanced MR cholangiography[J]. J Magn Reson Imaging， 2008， 27(1)：209-211.
20. Chujo M， Okubo M， Okubo K， et al. Double common bile duct：report of a case[J]. Int Surg， 2009， 94(1)：23-26.
21. Paraskevas G， Papaziogas B， Ioannidis O， et al. Double commonbile duct：a case report[J]. Acta Chir Belg， 2009， 109(4)：507-509.
22. Lee JH， Lee KG， Song SY， et al. New type of double common bile duct[J]. ANZ J Surg， 2011， 81(3)：200-201.
23. Komuro H， Ono K， Hoshino N， et al. Bile duct duplication as a cause of distal bowel gas in neonatal duodenal obstruction[J]. J Pediatr Surg， 2011， 46(12)：2301-2304.
24. Kawakubo K， Isayama H， Sasahira N， et al. Double common bile duct visualized by SpyGlass cholangioscopy[J]. Endoscopy， 2012， 44(Suppl 2)：e136-e137.
25. Gupta V， Chandra A. Duplication of the extrahepatic bile duct[J]. Congenit Anom (Kyoto)， 2012， 52(3)：176-178.
26. Tahara K， Ishimaru Y， Fujino J， et al. Association of extrahepatic bile duct duplication with pancreaticobiliary maljunction and congenital biliary dilatation in children：a case report and literature review[J]. Surg Today， 2012 Jul 24. [Epub ahead of print].
27. Boyden EA. The problem of the double ductus choledochus (an interpretation of an accessory bile duct found attached to the pars superior of the duodenum)[J]. Anatom Rec， 1932， 55(1)：71-93.
28. Goor DA， Ebert PA. Anomalies of the biliary tract tree. Report of a repair of an accessory bile duct and review of the literature[J]. Arch Surg， 1972， 104(3)：302-309.
29. Saito N， Nakano A， Arase M， et al. A case of duplication of the common bile duct with anomaly of the intrahepatic bile duct[J]. Nippon Geka Gakkai Zasshi， 1988， 89(8)：1296-1301.
30. Choi E， Byun JH， Park BJ， et al. Duplication of the extrahepatic bile duct with nomalous union of the pancreaticobiliary ductalsystem revealed by MR cholangiopancreatography[J]. Br J Radiol，.
31. Hashimoto M， Okuda C， Shida K， et al. Double hepatic duct associated with anomalous pancreatobiliary ductal junction[J]. Am J Surg， 2004， 187(3)：433.
32. Turmezei T， Ramjas G， Kumaran M. Extrahepatic bile duct duplication with choledocholithiasis in an accessory left bile duct draining into the antrum of the stomach：A case report[J]. Eur J Radiol Extra， 2010， 75(1)：e21-e25.
33. 谢扬信，徐成君. 胆总管重复畸形并结石致急性梗阻性化脓性胆管炎1例报告[J]. 中国普外基础与临床杂志， 2000， 9(5)：307.
34. 梁宏. 先天性肝总管及胆总管缺失伴双胆管畸型1例报告[J]. 中国普外基础与临床杂志， 2000， 7(3)：204.
35. 杨熙章，黄艺. 先天性双胆总管畸形1例[J]. 医学髟像学杂志， 2004， 14(11)：911.
36. 张启林，吴强. 先天性双胆总管畸形1例[J]. 中国普通外科杂志， 1997， 6(4)：216.
37. 杨毅，袁通立，刘培. 腹腔镜胆囊切除术中罕见胆道变异1例[J]. 中国普通外科杂志， 2012， 21(4)：1040.
38. 黄庆宁. B超诊断左右肝管异位汇人胰腺管1例[J]. 中华医学研究杂志， 2003， 3(4)：372.
39. 张仕林，李明珍. 胆道下段双管畸形并肝管狭窄1例[J]. 黔南民族医专学报， 2002， 15(2)：66.
40. 邓靖. 胆总管胆囊管重复畸形1例[J]. 肝胆外科杂志， 1996， 4(3)：133.
41. 孙伟，黄成钰，何峰. 胆总管内壁部分倒袋畸形1例[J]. 浙江医学， 2002， 24(7)：443.
42. 茆怀海. 肝外胆道变异1例[J]. 中华临床解剖杂志， 1996， 14(1)：37.
43. 张群伟，朱建峰. 肝外胆道畸形一例[J]. 肝胆外科杂志， 1995， 7(4)：35.
44. 刘佐军，孙立新，刘勇. 双胆总管畸形1例[J]. 中国普通外科杂志， 2005， 14(5)：364.
45. 严继生，魏希亮，刘启武等. 双胆总管畸形2例报告[J]. 河北职工医学院学报， 2003， 20(3)：19.
46. 赵亚新，周斌，蒋平. 双胆总管畸形伴巨大多发结石一例[J]. 中华肝胆外科杂志， 2004， 10(9)：615.
47. 王锡麟，陆建清，殷伯琦等. 双胆总管畸形伴双侧结石一例[J]. 肝胆胰外科杂志， 1999， 11(1)：10.
48. 李忠友，戴宗晴. 双肝管畸形一例[J]. 临床外科杂志， 2000， 8(3)：171.
49. 胡伯良. 双重肝内外胆道畸形1例报告[J]. 中国实用外科杂志， 1994， 14(3)：163.
50. 汪礼俊. 先天性胆总管管腔膜状分隔畸形致结石一例报道[J]. 腹部外科， 2004， 17(1)：151.
51. 徐振华. 先天性胆总管畸形一例[J]. 内蒙古医学杂志， 1998， 30(2)：78.
52. 程良忠. 先天性胆总管内膈膜畸形1例[J]. 中国普通外科杂志， 2000， 9(2)：116.
53. 翁伟健. 先天性肝内外胆管重复畸形伴结石1例[J]. 局部手术学杂志， 1997， 63(5)：56.
54. 李耀辉，李国胜，袁鲁明. 先天性肝外双腔胆管畸形二例[J]. 肝胆胰外科杂志， 1997， 9(1)：2.
55. 张二勇. 左右肝管前后重叠畸形1例报告[J]. 现代诊断与治疗， 1996， 7(6)：361.
56. 张铭恩，周淮彬，马玉春，等. 先天性双胆总管双乳头畸形舍并结石1例[J]. 中国实用外科杂志， 1996年， 6(2)：119.
57. 杨捷，罗云，杨复元. 先天性肝总管、胆总管及胆囊缺失伴双胆管畸形1例[J]. 大理学院学报， 2006， 5(10)：92.
58. ， 131(6)：676-681.
59. ， 80(955)：e150-e154.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Report of Two Cases of Type Ⅴb of Double Common Bile Duct and Review of The Literature

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