Double Cystic Ducts With The Single Gallbladder

Background: Cystic duct is forming one of the boundaries of triangle of cholecystectomy. The variations in cystic duct anatomy are of considerable importance during surgical excision of the gallbladder. A double cystic duct is very rare and poses a challenge for surgeons during cholecystectomy operation. If duplication of cystic ducts is present, it is associated with a double gallbladder 80% of the time. Presence of duplication of cystic duct associated with a single gallbladder is a extremely rare variant. Most of the times this variation is not picked up on routine preoperative investigations of patients planned for a laparoscopic cholecystectomy and often present as an unusual ‘surprise’ during surgery and creates a challenge to the surgeons. If they fail to identify this very rare variation they may create iatrogenic injury to these cystic ducts, which leads to bile leakage and other complications. Aim of the study: To find out the incidence of variations in the number of cystic duct in cadavers. Materials and Methods: Present study was done in 50 adult cadavers in the Department of Anatomy, Government Tiruvannamalai medical college, Tamil nadu. Meticulous dissection was done in the hepatobiliary system of these cadavers, and the variations in the number of cystic duct were noted. Observations: Presence of double cystic ducts were seen in three cadavers. Conclusion: If an anomaly of the biliary ductal system is not identified before or during surgery, it may turn out to be a bile duct injury which leads to bile leak. Hence Surgeons should keep in mind about the possibility of this rare variant double cystic ducts with a single gallbladder while performing cholecystectomy surgery. KEY WORDS: Cystic duct, Gallbladder, Cholecystectomy.