Anomalous insertion of the right hepatic duct into the cystic duct: report of a case diagnosed before laparoscopic cholecystectomy.

Although an aberrant hepatic duct entering the cystic duct is not especially rare, the main right hepatic duct entering the cystic duct is extremely rare, with only six cases reported thus far. All of the reported patients underwent open cholecystectomy, during which one patient received a bile duct injury. The anomaly was unsuspected preoperatively in all of these cases. We report an additional patient with this anomaly, the first such case diagnosed before laparoscopic cholecystectomy using direct cholangiography. Cholangiography may be mandatory whenever biliary anomalies are suspected during laparoscopic cholecystectomy. As the right hepatic duct entering the cystic duct can lead to ductal injury, this anomaly should be kept in mind when performing laparoscopic cholecystectomy.