A CASE OF CYSTIC DILATATAION OF THE COMMON BILE DUCT WITH THE LEFT SIDED GALLBLADDER

A 39-year-old woman was admitted to the hospital because of right vague hypochondralgia lasting for several months. Preoperative imagings indicated a 60×38mm cystic dilatation of the common bile duct, anomalous arrangement of pancreatobiliary duct, and and intracystic stones, but location of the gallbladder could not be predicted. Routine laboratory tests revealed no abnormality except for slight elevation in the levels of alkaline phosphatase, γ-glutamyl transpeptidase and leucine aminopeptidase. Resection of the cyst and the gallbladder reconstructed with hepatico-jejunostomy (Roux-Y) was performed. At laparotomy the gallbladder was found to be attaching to the lateral segment of the left lobe of the liver with a thin membranous mesenterial structure. A Biochemistry of the contents of both the cyst and gallbladder revealed marked elevation in amylase value being compatible with the finding of anomalous arrangement of pancreatico-biliary duct. Histological examination of the cyst and gallbladder showed chronic inflammation of the mucosa with no evidence of malignancy. Since 1970 when left-sided gallbladder was first reported in Japan, 38 cases including this case have been seen in the literature. This case of the disease accompanying by congenital cystic dilatation of the common bile duct is the first adalt case in Japan as for as we could review.