Obstructive jaundice caused by absence of common bile duct: A case report

Absence of the common bile duct is a rare biliary anomaly. The bile drains into the gallbladder directly via the cholecystohepatic ducts and into the duodenum through the cystic duct. The pre-operative diagnosis is difficult and may be confused with the choledochal cyst or hydrops of the gallbladder. Nonawareness of this anomaly will lead to dreaded complications during biliary surgery, such as bile leakage or hepatic duct injury. We presented one case of such a rare anomaly. A 57-year-old male patient presenting with progressive jaundice was admitted under the impression of obstructive jaundice. After a series of examinations, choledochal cyst was suspected. During the operation, absence of common bile duct with two hepatic ducts draining directly into the gallbladder was noted. The bile drained into the duodenum through the cystic duct. Total excision of the extrahepatic biliary system with Roux-en-Y hepaticojejunostomy reconstruction was performed. The post-operative course was uneventful and the patient was discharged on the 9th post-op day. He has been regularly followed up for 5 years without any biliary complication.