MRCPとDIC-CTにて重複胆囊管と術前診断できた1例

A case of double cystic duct diagnosed preoperatively by MRCP and DIC-CT

◆要旨：重複胆囊管は胆囊管の走行異常の中でも稀であり，術前診断が困難であることが多い．患者は26歳，女性．2023年10月から腹痛と下痢を認め，胆囊結石症と診断され当科紹介となった．術前のMRCP，DIC-CTにて重複胆囊管を認め，腹腔鏡下胆囊摘出術を施行した．2本の胆囊管を確認しクリップで結紮，切離し手術を終了した．重複胆囊管は術中胆管損傷の原因の1つであり術前診断が重要となる．今回われわれは， MRCPおよびDIC-CTを行うことで重複胆囊管と術前診断でき，胆管損傷することなく腹腔鏡下胆囊摘出術を施行した胆囊結石症の1例を経験したので，若干の考察を加えて報告する．

　Duplicate choledochal ducts are rare among the abnormalities of the cystic duct, and are often difficult to diagnose preoperatively. A 26-year-old woman complaining of abdominal pain and diarrhea was admitted to the hospital in 2023 with a diagnosis of cholecystolithiasis. The double cystic duct was diagnosed before the operation by MRCP and DIC-CT, and the operation was performed. Two cystic ducts were ligated with clips and were resected. Preoperative diagnosis of double cystic duct is very important because double cystic duct is one of the cause of intraoperative injury of the bile duct. We diagnosed a patient with double cystic duct using MRCP and DIC-CT, and performed laparoscopic operation with no injury of the bile duct. The case is reported with some literature review.