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SLNDAR seems to be a feasible procedure in locally recurrent breast cancer and can spare a clinically significant number of patients an unnecessary ALND and the following risk of sequelae. In patients who had previous ALND, SLNDAR identified metastases that would have been overlooked following the current guidelines. A large proportion of patients had aberrant drainage, suggesting a need for lymphoscintigraphy.

A case of an accessory common bile duct inserting near or on the minor duodenal papilla revealed by ERCP. The patient had no symptoms related to the anomaly. A review of the literature revealed 23 cases from the last 500 years. The accessory bile ducts opened into the gastrointestinal tract at different distances from the major duodenal papilla. In certain animals a double common bile duct is normal. The anomalies are assumed to be caused by random subdivisioning of the hepatic diverticulum early in organogenesis.