{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T13:19:29Z","timestamp":1764249569759,"version":"3.46.0"},"reference-count":16,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,11,6]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>This case report presents a rare anatomical anomaly of a double-lumen cystic duct identified while performing a robot-assisted laparoscopic cholecystectomy for a patient with symptomatic cholelithiasis. The use of indocyanine green cholangiography for the procedure allowed the surgical team to confirm that the cystic duct was in fact the structure that was appropriately surgically severed, reducing the concern for potential surgical complications. This case is unique due to the lack of recorded literature describing a double-lumen cystic duct. By reporting this finding, we hope to increase awareness of the potential for such anatomical aberrations and highlight the importance of indocyanine green imaging in cholecystectomies.<\/jats:p>","DOI":"10.1136\/bcr-2025-268826","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T13:15:18Z","timestamp":1764249318000},"page":"e268826","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Double-lumen cystic duct identified during robot-assisted laparoscopic cholecystectomy"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0500-3221","authenticated-orcid":false,"given":"Christopher Plapparampil","family":"Benny","sequence":"first","affiliation":[{"name":"Medical School, Medical College of Wisconsin - Central Wisconsin Campus, Wausau, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Michalicka","sequence":"additional","affiliation":[{"name":"SSM Health Monroe Clinic Medical Group, General Surgery, SSM Health Care of Wisconsin, Monroe, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"2025112705150947000_18.11.e268826.1","unstructured":"Jones MW , Guay E , Deppen JG . Open cholecystectomy. In: StatPearls. StatPearls Publishing, 2025. Available: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK448176\/"},{"key":"2025112705150947000_18.11.e268826.2","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1159\/000471818","article-title":"Bile Duct Injury after Cholecystectomy: Surgical Therapy","volume":"33","author":"Renz","year":"2017","journal-title":"Visc Med"},{"key":"2025112705150947000_18.11.e268826.3","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1016\/j.jamcollsurg.2017.12.023","article-title":"Diminished Survival in Patients with Bile Leak and Ductal Injury: Management Strategy and Outcomes","volume":"226","author":"Fong","year":"2018","journal-title":"J Am Coll Surg"},{"key":"2025112705150947000_18.11.e268826.4","doi-asserted-by":"crossref","first-page":"2239","DOI":"10.1007\/s00464-015-4485-2","article-title":"Beyond the learning curve: incidence of bile duct injuries following laparoscopic cholecystectomy normalize to open in the modern era","volume":"30","author":"Halbert","year":"2016","journal-title":"Surg Endosc"},{"key":"2025112705150947000_18.11.e268826.5","doi-asserted-by":"crossref","DOI":"10.1155\/2024\/3877814","article-title":"Anatomical Variations of the Gallbladder and Bile Ducts: An MRI Study","volume":"2024","author":"Yason","year":"2024","journal-title":"Int J Hepatol"},{"key":"2025112705150947000_18.11.e268826.6","doi-asserted-by":"crossref","first-page":"273","DOI":"10.4103\/jmas.JMAS_268_16","article-title":"Clinical reappraisal of vasculobiliary anatomy relevant to laparoscopic cholecystectomy","volume":"13","author":"Singh","year":"2017","journal-title":"J Min Access Surg"},{"key":"2025112705150947000_18.11.e268826.7","doi-asserted-by":"crossref","first-page":"51","DOI":"10.4103\/1319-3767.151231","article-title":"Common bile duct duplication: the more the murkier","volume":"21","author":"Arora","year":"2015","journal-title":"Saudi J Gastroenterol"},{"key":"2025112705150947000_18.11.e268826.8","doi-asserted-by":"crossref","DOI":"10.1186\/s12887-022-03708-1","article-title":"A proposed feasible classification of common bile duct duplications based on a newly described variant and review of existing literature","volume":"22","author":"Sheng","year":"2022","journal-title":"BMC Pediatr"},{"key":"2025112705150947000_18.11.e268826.9","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1111\/j.1741-4520.2011.00341.x","article-title":"Duplication of the extrahepatic bile duct","volume":"52","author":"Gupta","year":"2012","journal-title":"Congenit Anom (Kyoto)"},{"key":"2025112705150947000_18.11.e268826.10","unstructured":"Frontiers | double cystic duct: preoperative use of mrcp without being aware of the anatomic anomaly: a case report. Available: https:\/\/www.frontiersin.org\/journals\/surgery\/articles\/10.3389\/fsurg.2022.892927\/full [Accessed 13 Mar 2025]."},{"key":"2025112705150947000_18.11.e268826.11","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1007\/s11547-008-0298-x","article-title":"Congenital anomalies and variations of the bile and pancreatic ducts: magnetic resonance cholangiopancreatography findings, epidemiology and clinical significance","volume":"113","author":"De Filippo","year":"2008","journal-title":"Radiol med"},{"key":"2025112705150947000_18.11.e268826.12","doi-asserted-by":"crossref","first-page":"250","DOI":"10.12659\/PJR.895827","article-title":"Common and Uncommon Anatomical Variants of Intrahepatic Bile Ducts in Magnetic Resonance Cholangiopancreatography and its Clinical Implication","volume":"81","author":"Sarawagi","year":"2016","journal-title":"Pol J Radiol"},{"key":"2025112705150947000_18.11.e268826.13","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1007\/s11605-011-1802-5","article-title":"What is the duct of Luschka?--A systematic review","volume":"16","author":"Schnelldorfer","year":"2012","journal-title":"J Gastrointest Surg"},{"key":"2025112705150947000_18.11.e268826.14","doi-asserted-by":"crossref","DOI":"10.4293\/CRSLS.2020.00074","article-title":"Subvesical Duct Detected by Magnetic Resonance Cholangiopancreatography (MRCP) in a Patient with Bile Leak after Laparoscopic Cholecystectomy","volume":"8","author":"Lin","year":"2021","journal-title":"CRSLS"},{"key":"2025112705150947000_18.11.e268826.15","unstructured":"Persaud TVN , Torchia MG . Alimentary system. In: The Developing Human: Clinically Oriented Embryology. 12th edn. Elsevier, 2025."},{"key":"2025112705150947000_18.11.e268826.16","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/j.ciresp.2021.11.018","article-title":"Indocyanine green (ICG) fluorescence guide for the use and indications in general surgery: recommendations based on the descriptive review of the literature and the analysis of experience","volume":"100","author":"Morales-Conde","year":"2022","journal-title":"Cir Esp (Engl Ed)"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-268826","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T13:15:20Z","timestamp":1764249320000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-268826"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":16,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11,27]]},"published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1136\/bcr-2025-268826"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-268826","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]}}}