Abstract

Unexpected anomalies of the extrahepatic biliary ducts were found intraoperatively during open cholecystectomy in a 49-year-old male, with calcular obstructive jaundice. The patient had congenital absence of the common bile duct that appears to have been replaced by the cystic duct, which opened directly into the duodenum. The right and left hepatic ducts drained into the posterior wall of the gallbladder by a short common hepatic duct. Intraoperatively the gallbladder wall (with uncompromised nerve and blood supply) was used as a vital flap to reconstruct a tubular bridge across the defect in the biliary ducts, while retaining a functional sphincter of Oddi at the end of the original cystic duct.

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