A new variant of cholecystohepatic duct: MR cholangiography demonstration

Minutoli, Fabio; Naso, Serena; Visalli, Carmela; Iannelli, Dario; Silipigni, Salvatore; Pitrone, Alessia; Bottari, Antonio

doi:10.1007/s00276-014-1356-9

Cited by 9 publications

(9 citation statements)

References 10 publications

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“…According to the literature, the frequency of bile duct variations (except the typical pattern), varies between 28% and 43% (7,(14)(15)(16)(17)(18)(19). Our results are comparable with previously reported data: anatomic variation at the hepatic hilum was observed in 32.8% of the control group and 42.3% of the PD patients.…”

Section: Discussionsupporting

confidence: 82%

“…Since the most common variant is type 3a, in a patient with RPSD draining into LHD, ligation of the right posterior branch during left hepatectomy can cause biliary cirrhotic changes at Segments 6 and 7 (18). In addition, documentation of the ductal variations is important to prevent bilioma, bile peritonitis, biliary stricture, cholangitis, and abscess, which may occur due to biliary injuries (19).…”

Section: Discussionmentioning

confidence: 99%

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Frequency of bile duct confluence variations in subjects with pancreas divisum: an analysis of MRCP findings

Çoruh

Gülpınar

Baş

et al. 2018

Diagn Interv Radiol

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ongenital anomalies of the pancreatic duct may remain undiagnosed until adulthood and they are often diagnosed incidentally. Pancreas divisum (PD) is the most common congenital anomaly of the pancreas which occurs from a failure of ventral and dorsal bud fusion (1, 2). It accounts for about 4%-14% of the population at autopsy series, and approximately 9% are detected using magnetic resonance cholangiopancreatography (MRCP) (3). In PD, the ventral (Wirsung) duct opens into the major papilla without merging with the dorsal (Santorini) duct. The dorsal duct, which opens into the minor papilla, is responsible for the majority of the drainage from the pancreas. The clinical importance of PD is not clear. Most patients are asymptomatic, whereas in some patients, PD may cause recurrent pancreatitis due to lack of adequate drainage into duodenum via minor papilla (3, 4). Of patients with idiopathic recurrent pancreatitis, 12%-26% have PD (5). There are various type of examinations to evaluate the pancreaticobiliary system; however, MRCP has been shown to be an effective noninvasive imaging modality for the visualization of the biliary tree and pancreatic duct. Bret et al. (6) reported an accuracy rate of 100% in the diagnosis of PD using MRCP (6).Laparoscopic cholecystectomy, transplantation surgery, hepatic resection, and tumor surgery are the most common hepatobiliary surgeries in which complications related to the bile duct variations comprise one of the most common reasons for morbidity and mortality. PURPOSEWe aimed to evaluate the frequency of bile duct branching pattern variations at the hepatic confluence in patients with pancreas divisum (PD). METHODSA search was performed through the hospital database using the keyword "pancreas divisum" to identify patients. The magnetic resonance cholangiopancreatography (MRCP) images of 137 patients who were diagnosed with PD between August 2011 and November 2016 were retrospectively analyzed for the presence of bile duct variations. A control group of 137 patients without PD was established among patients investigated during the same period. Variations of the biliary tract were grouped into seven types according to the McSweeney et al. classification. RESULTSBiliary tract variations were detected in 103 of a total of 274 patients. Fifty-eight PD patients (42.3%) and 45 control patients (32.8%) had bile duct variation at the hepatic confluence level. The patients with PD were more likely to have biliary tract variation compared with the control group; however, it was not statistically significant (P = 0.105). The most common variation in PD patients was type 3a variation (16.8%). CONCLUSIONMRCP studies showed atypical bile duct confluence pattern in nearly half of both PD patients and controls. There was no statistically significant difference in the frequency of anatomic variations at bile duct confluence in patients with PD versus those without PD. Derivation of these structures from different outpouchings in early embryological life may explain this insignificant differ...

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Frequency of bile duct confluence variations in subjects with pancreas divisum: an analysis of MRCP findings

Çoruh

Gülpınar

Baş

et al. 2018

Diagn Interv Radiol

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“…Laparoscopic surgery has become the standard approach for cholecystectomy (21). As biliary tract variations are observed quite often, an evaluation of bile duct variations with MRCP before laparoscopic cholecystectomy is very important to prevent biliary complications because of ductal injuries such as bile leakage, bile peritonitis, biliary stricture, obstructive jaundice, and liver abscess (21).…”

Section: Discussionmentioning

confidence: 99%

“…As biliary tract variations are observed quite often, an evaluation of bile duct variations with MRCP before laparoscopic cholecystectomy is very important to prevent biliary complications because of ductal injuries such as bile leakage, bile peritonitis, biliary stricture, obstructive jaundice, and liver abscess (21). Poor visualization of the cystic duct during surgery may cause accidental bile duct injury.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance cholangiopancreatography evaluation of intrahepatic bile duct variations with updated classification

Nayman

Özbek²,

Erol³

et al. 2016

Diagn Interv Radiol

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“…Tomando en consideración lo anteriormente expuesto, el conducto subvesicular encontrado en este trabajo corresponde a un hepático-cístico. A su vez, algunos autores sugieren diferenciar el conducto hepático-cístico, como en este caso, del conducto cístico-hepático, en donde el conducto involucrado drena directamente parénquima hepático en dirección a la vesícula biliar (Minutoli et al, 2015). Respecto a la embriología de estas variantes, se infiere que son producto de comunicaciones anormales producidas en la etapa fetal que no revierten al completar el desarrollo (Kocabiyik et al, 2009).…”

Section: Discussionunclassified

CONDUCTO BILIAR SUBVESICULAR: HALLAZGO QUIRÚRGICO Y COLANGIOGRÁFICO. Sub-gallbladder bile duct: Surgical and colangiographic findings

Russo

Sciuto

2016

Rev Arg de Anat Clin

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RESUMENLas variaciones de la vía biliar son frecuentes y pueden provocar complicaciones en el curso de una colecistectomía. Por esta razón el cirujano debe estar interiorizado en la anatomía habitual así como en las posibles variantes. Presentamos un caso de un conducto biliar subvesicular encontrando durante una colecistectomía. Se trató de un conducto que se originaba en el conducto hepático derecho y terminaba en la vesícula biliar. Se procedió a la ligadura del mismo y su posterior sección. El paciente tuvo una buena evolución y fue dado de alta a las 48 horas del posoperatorio. En vistas a este hallazgo se discuten la anatomía y las implicancias quirúrgicas de esta variante. Palabras clave: anatomía, vía biliar, colecistectomía, variación ABSTRACTVariations in the biliary tract are frequent and may cause complications during a cholecystectomy. Thus, the surgeon must have a deep knowledge of the usual configuration of the biliary tract as well as its variations. We report a case of a subvesical bile duct found during a cholecystectomy. It consisted of a bile duct which originated from the right hepatic duct and ended in the gallbladder. The duct was clipped and cut, the patient had good evolution and was discharged 48 hours after surgery. The anatomy and surgical implications of this variation are discussed.

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A new variant of cholecystohepatic duct: MR cholangiography demonstration

Cited by 9 publications

References 10 publications

Frequency of bile duct confluence variations in subjects with pancreas divisum: an analysis of MRCP findings

Frequency of bile duct confluence variations in subjects with pancreas divisum: an analysis of MRCP findings

Magnetic resonance cholangiopancreatography evaluation of intrahepatic bile duct variations with updated classification

CONDUCTO BILIAR SUBVESICULAR: HALLAZGO QUIRÚRGICO Y COLANGIOGRÁFICO. Sub-gallbladder bile duct: Surgical and colangiographic findings

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