Successful diagnosis and treatment of double common bile duct with cholelithiasis by laparoscopic cholecystectomy

Double common bile duct (DCBD) is an extremely rare congenital anomaly of the biliary system associated with serious complications. An association between DCBD and inadvertent bile duct injury during surgery has been reported. However, DCBD is difficult to diagnose preoperatively. We report a rare case of DCBD (type 3b), combined with cholelithiasis and cholecystitis, diagnosed preoperatively, and treated safely by laparoscopic cholecystectomy. A 79-year-old woman was admitted with a 1-week history of chest pain. Abdominal computed tomography revealed gallbladder distension with obvious wall thickening. Laparoscopic cholecystectomy was planned to determine the presence of stones in the common bile duct and an anomalous biliary tract. Magnetic resonance cholangiopancreatography (MRCP) was performed, and anomalous anatomy of the biliary tract was suspected. Drip infusion cholangiography with computed tomography (DIC-CT) showed type 3b DCBD. On hospital day 7, laparoscopic cholecystectomy was performed without accessory common bile duct resection. The postoperative course was uneventful, and the patient was discharged on postoperative day 5. To our knowledge, this is the first report of the successful diagnosis of DCBD using DIC-CT. MRCP and DIC-CT can be useful for the pre-operative diagnosis of DCBD to decrease the risk of bile duct injury during surgery.