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Case Report
Ectopic bile duct: A case report and brief review
1 MBBS (Hons), General Surgery Registrar, General Surgery Unit, Northern Health, Epping, VIC 3076, Australia
2 MBBS, Resident Medical Officer, General Surgery Unit, Northern Health, Epping, VIC 3076, Australia
3 PhD, FRACS, Consultant Surgeon, General Surgery and Hepatopancreaticobiliary Unit, Northern Health, Epping, VIC 3076, Australia
Address correspondence to:
Xin Yi Goai
General Surgery Unit, Northern Health, 185 Cooper St, Epping, VIC 3076,
Australia
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Article ID: 100122Z12XG2023
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How to cite this article
Goai XY, Hsiao MM, Ashour M. Ectopic bile duct: A case report and brief review. J Case Rep Images Surg 2023;9(2):7–11.ABSTRACT
Introduction: An ectopic bile duct is the confluence of common bile duct (CBD) and main pancreatic duct away from its usual location in the posteromedial wall of the second part of duodenum. This increases risk of choledocholithiasis and pancreatitis, while proximal locations increase risk of duodenal ulceration and stenosis.
Case Report: A woman in her late forties was consented to elective laparoscopic cholecystectomy for symptoms of biliary colic and ultrasonographic features of a mobile gallstone. Intraoperative cholangiogram noted dilated biliary tree and main pancreatic duct despite normal liver function values, as well as an ectopic ampulla of Vater to distal third part of duodenum or proximal fourth part of duodenum. The distal bile duct had a longer common channel. The operation was otherwise uncomplicated. Magnetic resonance cholangiopancreatography demonstrated similar findings. The patient recovered uneventfully and was discharged from surgical services.
Conclusion: The gold standard for diagnosing ectopic bile ducts is via endoscopic retrograde cholangiopancreatography. Hepatobiliary anatomical variants can also occur in the location of the ampulla, thus it is important for surgeons and trainees to interpret and document this carefully during intraoperative cholangiogram, especially in patients who may require endoscopic retrograde cholangiopancreatography in the perioperative period and/or later date. The patient should be educated on the associated risks and red flags to seek medical attention.
Keywords: Cholecystectomy, Ectopic ampulla of Vater, Ectopic bile duct, Hepatopancreaticobiliary surgery, Laparoscopic surgery
SUPPORTING INFORMATION
Author Contributions
Xin Yi Goai - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Michelle Min Hsiao - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Mohamed Ashour - Substantial contributions to conception and design, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2023 Xin Yi Goai et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
