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Absence Of the Cystic Duct

Arch Surg. 1964;88(6):1077-1078. doi:10.1001/archsurg.1964.01310240173030.
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Introduction  Among the many anomalies of the biliary tree is interposition of the gallbladder between the common hepatic and common bile ducts. The existence of this anomaly has not been emphasized, since only 14 cases have appeared in the English medical literature, yet the failure to recognize this condition may have disastrous results.

Report of Case  This 67-year-old Creek Indian woman was admitted to Public Health Service Indian Hospital, Talihina, Okla, on Aug 27, 1963, with a perforated appendix. An appendectomy was performed during the course of which cholelithiasis was noted to be present. Postoperative course was uneventful until Sept 13, when she developed an attack of acute cholecystitis which subsided on conservative management. Because of intermittent right upper quadrant distress, patient was taken to surgery on Sept 23, for cholecystectomy.Exploration revealed the gallbladder to be solidly packed with stones and adherent to surrounding viscera. After lysis of adhesions,


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