Accessory bile duct and laparoscopic cholangiography: report of three cases

Laparoscopic cholangiography can be useful in identifying an accessory bile duct. Failure to identify an accessory bile duct during laparoscopic cholangiography may lead to complications and prolonged hospitalizations. At times, the accessory duct can be clearly seen filling with contrast; at other times, the only clue to the possible presence of an accessory duct is opacification of the gallbladder. If the cystic duct has been clipped on the gallbladder side of the cholangiocatheter, the only way for the gallbladder to fill is through an accessory duct. If the actual accessory duct cannot be demonstrated and ligated, then drains should be placed in the gallbladder bed. The three cases presented here illustrate these points.