TY - JOUR T1 - Laparoscopic surgery for congenital biliary dilatation accompanied by accessory hepatic ducts: a report of seven cases JF - World Journal of Pediatric Surgery JO - World Jnl Ped Surgery DO - 10.1136/wjps-2021-000359 VL - 5 IS - 2 SP - e000359 AU - Yuebin Zhang AU - Jia Yu AU - Chen Qingjiang AU - Duote Cai AU - Zhigang Gao Y1 - 2022/02/01 UR - http://wjps.bmj.com/content/5/2/e000359.abstract N2 - Congenital biliary dilatation (CBD) is a congenital biliary tract anomaly characterized by expansion of the common bile duct and is thus known clinically as a choledochal cyst. The form of CBD varies, and the commonly used clinical classification was described by Todani et al.1 Pancreaticobiliary maljunction is reported to be present in 30%–96% of patients with CBD.2 3 The main aims of laparoscopic surgery include resection of the dilated biliary ducts, gallbladder, pancreatic-bile diversion, and biliary tract reconstruction.4 Accessory hepatic ducts (AHDs) are extrasegmental bile ducts that often drain a part of the liver and can join the biliary system at any position, such as the common bile duct, common hepatic duct (CHD), right hepatic duct or the gallbladder. AHDs are seldom seen on preoperative imaging, but they increase the difficulty of surgery and the risk of postoperative biliary fistula.5 6 A retrospective analysis of treatment outcome in 7 of 542 patients with AHDs who received surgical treatment in our center from January 2012 to August 2020 was conducted.A total of 542 patients received CBD surgery in the Department of General Surgery, Zhejiang University Children’s Hospital from January 2012 to August 2020. Most of the patients presented with typical choledochal dilatation during surgery and underwent classic cholecystectomy with dilated biliary duct and Roux-en-Y anastomosis of the hepatic duct and jejunum. Of these 542 cases, 7 patients had anatomic variations of AHDs, and choledochojejunostomy was performed differently. Of these seven patients, two were male and five were female, with an average age of 23.5 months, ranging from 2 to 48 months. Only one case was identified by preoperative magnetic resonance cholangiopancreatography (MRCP) as having AHDs (figure 1), and the rest were found intraoperatively. Of these seven cases, two cases were found to have choledochal cysts … ER -