Single gallbladder with doubled cystic duct is a relatively rare congenital malformation. Up until late 2017, only 20 patients were reported with duplicated cystic duct. Misdiagnosis of this condition may lead to bile duct injury and more complications. Conducting a sensitive imaging test may help prevent damage in suspected patients.

In the present study, we reported a 58-year-old female with doubled cystic duct who initially presented with a passed stone and pancreatitis concomitant with a gallbladder containing microlithiasis. Despite performing endoscopic ultrasonography preoperatively, there was no doubt about anomaly and doubled cystic duct was diagnosed incidentally during laparoscopic cholecystectomy. The patient had no complications after the surgery and relieved uneventfully. Postoperative magnetic resonance cholangiography (MRCP) showed normal biliary tree structure.

This study highlights the point that despite all recent advances in imaging techniques, still there are limitations in visualizing cystic duct anatomic variations. Therefore, it is important to keep a watchful eye on the anatomy during the surgery, even if preoperative imaging test revealed normal findings.