A rare case report of gastric cancer complicated by ectopic drainage of the accessory common bile duct into the stomach and corresponding surgical strategies

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Background: Double common bile duct (DCBD) is a rare congenital anomaly, with accessory common bile duct (ACBD) ectopic drainage into the stomach being extremely uncommon and rarely linked to gastric cancer. Case report: A 48-year-old male with 2-month intermittent retrosternal painand 4-day melena was diagnosed via gastroscopy and pathology. ACBD was intraoperatively misidentified as the accessory left hepatic artery and transected, resulting in bile leakage. He underwent subtotal gastrectomy with Roux-en-Y gastrojejunostomy, D2 lymphadenectomy jejunojejunal end-to-side anastomosis, and choledochojejunostomy, with intraoperative videos, specimen images and pathology reports provided. The reconstructed accessory common bile duct showed unobstructed drainage. Conclusion: This case highlights the importance of accurate ACBD diagnosis and proper surgical management, and summarizes relevant surgical strategies, offering reference for similar cases.

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