Anomalies of the biliary ducts are a constant source of concern to physicians performing surgery in that area. Numerous variations in the position and length of the cystic duct as well as the cystic artery have been described in detail. Mention has frequently been made of aberrant hepatocystic ducts; however, absence of the common bile duct, discussed in the following case report, has been reported briefly only once before, when it occurred in an infant who died because of this anomaly. The ducts were all atretic.1
This anatomic variation, if it had not been recognized in the usual technical performance of cholecystectomy, would surely have led to death or unfortunate complications. The maneuver emphasized by Gatch2 of tracing the biliary ducts from within after emptying the gallbladder was helpful in tracing the anomaly. This procedure is a sound, valuable aid in preventing surgical accidents in the biliary ducts.
Sachs AE. ABSENCE OF COMMON BILE DUCT. JAMA. 1952;149(16):1462–1463. doi:10.1001/jama.1952.72930330003009a
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