Anomalous Insertion of the Cystic Duct into the Right Hepatic Duct: A Rare Presentation

Abstract Laparoscopic cholecystectomy is one of the most frequently performed procedures using minimally invasive techniques. Typically, the cystic duct joins the common hepatic duct; however, in rare cases, it may drain into the right hepatic duct. We report a case of a 45-year-old woman with cholelithiasis, in which the cystic duct was found to join the right hepatic duct, an anatomical variation observed in only 0.3%–0.4% of cases. Although preoperative imaging techniques, such as magnetic resonance cholangiopancreatography or endoscopic retrograde cholangiopancreatography can assist in identifying such anomalies, they are rarely performed in uncomplicated cases. Intraoperative cholangiography or indocyanine green fluorescence imaging can be valuable during surgery to visualize abnormal biliary and vascular anatomy. Ensuring proper visualization of the critical view of safety and maintaining awareness of common biliary tree variations are essential to prevent injury and minimize complications.