We present herein the case of a 70-year-old man with biliary tree dilation due to pancreatic head adenocarcinoma. As shown in Figure 1, given the failure of endoscopic drainage of the common bile duct (CBD), the patient underwent percutaneous internal-external biliary drainage (2 arrows) with restoration of normal bile passage from the liver into the duodenum (#). The final cholangiography demonstrated dilated biliary ducts and an anatomic variant, with an aberrant posterior branch of the right hepatic duct (PB-RHD) and the cystic duct (CD) draining into the common hepatic duct (CHD) together in a “Y” course. Steno-occlusion of the CBD was confirmed (*). The rest of the biliary tree appeared normal: the anterior branch of the right hepatic duct (AB-RHD), the left hepatic duct (LHD), and the gallbladder.
The patient underwent biliary stenting and subsequent oncologic therapy.
The bile duct system arises from the hepatic diverticulum at the fourth embryonic week. Parts of those ducts later form the definitive hepatic duct pattern, but anatomic variants may occur during that process. If there is no knowledge of biliary tree anatomic variants, they can lead to bile duct injury during hepatic surgery. A clear characterization through imaging studies of the patient’s biliary anatomy provides important information for hepatic surgery planning and maneuvering.
Ethical disclosuresProtection of human and animal subjectsThe authors declare that no experiments were performed on humans or animals for this study.
Confidentiality of dataThe authors declare that they have treated all patient data with confidentiality and anonymity, following the protocols of their work center.
Right to privacy and informed consentThe authors have followed the protocols of their work center in relation to the publication of patient data, preserving absolute patient confidentiality and anonymity.
Financial supportNo financial support was received in relation to this article.
Conflict of interestThe authors declare that there is no conflict of interest.
Please cite this article as: Rossi UG, Ierardi AM, Cariati M. Drenaje de conducto hepático derecho aberrante y conducto cístico hacia el conducto hepático común. Revista de Gastroenterología de México. 2020;85:354–355.
