Introduction: Anatomical variations of the biliary tree are a well-recognized cause of bile duct injury during laparoscopic cholecystectomy. Among these, duplication of the cystic duct associated with a single gallbladder is an extremely rare congenital anomaly and is often diagnosed intraoperatively due to limitations of preoperative imaging.
Case Presentation: We report a case of a 37-year-old female who presented with intermittent epigastric and right upper quadrant pain for one year. Ultrasonography revealed multiple gallbladder calculi. During laparoscopic cholecystectomy, a single gallbladder with double cystic duct anatomy was identified intraoperatively.
Discussion: Duplicated cystic ducts significantly increase the risk of bile duct injury if unrecognized. Although imaging modalities such as magnetic resonance cholangiopancreatography and intraoperative cholangiography may aid in delineating biliary anatomy, they may fail to detect rare ductal anomalies. Careful dissection and adherence to the critical view of safety remain essential.
Conclusion: This case highlights the importance of awareness of rare biliary anatomical variations and meticulous intraoperative assessment to prevent bile duct injury during laparoscopic cholecystectomy.