Anatomical variations of the extrahepatic biliary tree: Review of the world literature

Lamah, M.; Karanjia, N D; Dickson, G. H.

doi:10.1002/ca.1028

Cited by 100 publications

(87 citation statements)

References 39 publications

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“…Aberrant ducts which communicate the right hepatic lobe directly with the gallbladder have also been described (Foster & Wayson, 1962;Lamah et al, 2001;Cavalcanti et al) The cystic duct has three common variations: a) insertion into the distal third of the common hepatic duct (9%); b) medial insertion through the left side of the common hepatic duct (10-17%); c) course parallel to the common hepatic duct extending for 2 cm or more (1.5%-25%) according to Turner & Fulcher (2001). On the other hand, insertion of the cystic duct into the left or right hepatic ducts, or influence of the left posterior hepatic duct directly into the cystic duct are considered rare (Turner & Fulcher;Yamakawa et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Anatomic Variations of Extrahepatic Bile Ducts and Evaluation of the Length of Ducts Composing the Cystohepatic Triangle

2012

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SUMMARY:It is of paramount importance for surgeons to have a thorough knowledge of the normal anatomy of the extrahepatic bile ducts and its variations due to the high frequency with which they perform in this anatomic site. The cystohepatic triangle, or Calot's Triangle, is bound by the cystic duct, common hepatic duct, and the hepatic border; therefore, its surface area depends on the conformation of these ducts and is closely linked to surgical procedures performed in this region. It has been reported that the length and the position of these ducts may be related to the formation of bile duct stones, Mirizzi's syndrome, and bile duct cancer. Thus, the present work aims to analyze the configuration of the extrahepatic biliary tree and its possible variations, as well as measure the components that make up the cystohepatic triangle. For this task 41 samples from fixated human cadavers were analyzed, with 25 consisting of anatomic parts (liver and biliary tree) and 16 in situ samples. The extrahepatic biliary trees were dissected in order to measure the length of the common hepatic and cystic ducts with a digital caliper, and all anatomic variations were registered. The length of the common hepatic duct varied between 4.18 mm and 50.64 mm, with an average of 21.76 ± 9.51 mm. The length of the cystic duct varied between 7.28 and 38.88 mm, with an average of 19.11 ± 6.77 mm. Anatomic variations were found in 3 samples (7.3%): in one of them the cystic duct connected to the left hepatic duct; in another, the cystic duct connected to the right hepatic duct; in the third, there was a triple confluence of hepatic ducts (two right ducts and one left duct). The results are a contribution to the clinical and surgical anatomy of this region.

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Section: Introductionmentioning

confidence: 99%

Anatomic Variations of Extrahepatic Bile Ducts and Evaluation of the Length of Ducts Composing the Cystohepatic Triangle

2012

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“…This less than figures found in international data. This variation incidence varied from 8.3% to 14% in an autopsy series (Lamah 2001). In Korea, 10,243 ERCP cases were studied in a prospective way showed the cystic duct variations in 16.9% of the patients.…”

Section: Discussionmentioning

confidence: 92%

Anatomical variations of the hepatobiliary system in Sudanese patients undergoing endoscopic retrograde cholangiopancreatography (ERCP)

Doush¹,

A-Galil

Ibrahim

2017

IJM

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Background: The meticulous identification of the hepatobiliary tree system normal anatomy during surgical operations is crucial in iatrogenic injury prevention. Equally important, an understanding of the congenital variations of biliary and vascular anatomy, as the literature abounds with reports of specific anatomical variations, and their surgical implications. Aim: This study aimed to study the presence of anatomical variations within the hepatobiliary system in Sudanese population undergoing endoscopic retrograde cholangiopancreatography (ERCP). Patients and methods:The records of patients undergoing ERCP in Soba University Hospital during 2004 to 2008 were analyzed. There were 277 Sudanese patients who had complained of right hypochondrial abdominal pain & history of jaundice (obstructive jaundice) that underwent ERCP were included within this study. The exclusion criteria included the following: Sudanese patients in whom ERCP failed or patients who had advanced hepatobiliary disease like cancers, strictures either cancerous or iatrogenic, fistula and iatrogenic biliary leak. Results: The analysis of 277 Sudanese patients undergoing ERCP of the hepatobiliary system showed the following results regarding the variations: The choledochal cyst type one (fusiform type) was present in 3 (1.08%) patients; very low cystic duct insertion (parallel) was present in 1 (0.36%) patient and long cystic duct was present in 3 (1.08%) patients. The ampulla of Vater size variations occurred as A) Normal in 158 (57%) patient, B) Small in 56 (20.2%) patients, C) Large in 29 (10.5%) patients, D) Periampullary diverticula in 4 (1.4%) patients and E) unclassified in 30 (10.8%) patients. Other forms of congenital anomalies were not found. Conclusion: The using of endoscopic retrograde cholangiopancreatography (ERCP) is a reliable radiological method for depicting congenital anomalies of the hepatobiliary system, but it is an invasive procedure.

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“…It is thought to be due to exuberant budding of the developing biliary tree when the caudal bud of the hepatic diverticulum divides [6,7].On the other side choledochal cysts are also rare, with an incidence of 1:100000-1500008. [2].…”

Section: Discussionmentioning

confidence: 99%

“…Senecail et al found morphologic variations and abnormalities in more than 33% but only 3 cases of real duplication from ultrasonographic exploration of the gallbladder performed on 1823 patients [8]. Anatomic variants of gallbladder duplication are still differentiated according to Boyden's classification as follows ( Figure 5) [1,6]:Choledocal cyst classification commonly accepted is one devised by Todani et al (Figure 6), that 5 main types are described.…”

Section: Discussionmentioning

confidence: 99%

Duplication of the Gallbladder Associated with Choledocal Cyst: A Case Report

2016

IJSR

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Introduction: Gallbladder duplication is a rare anatomic malformation, which can now be detected by preoperative imaging study. Case presentation: This is a retrospective case report of 39-year-old woman presented during a routine US (ultrasonography) examination complaining intermittent abdominal pain in the upper right quadrant. Laboratory examinations found normal values of total bilirubin, transaminases and alkaline phosphatase. US examination of the right upper quadrant was performed. It was noticed that the gallbladder was duplicated, but there were no distended wall thickening or presence of gallstone. A cystic lesion was noticed that was firstly identified as a pancreatic cyst. The MR cholangiography showed duplicated gallbladder with two cystic ducts and a choledochal cyst. Conclusion: Duplication of the gallbladder is a rare congenital abnormality, which requires special attention to the biliary ductal and arterial anatomy. Laparoscopic cholecystectomy with intraoperative cholangiography seems to be the appropriate treatment.

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Anatomical variations of the extrahepatic biliary tree: Review of the world literature

Cited by 100 publications

References 39 publications

Anatomic Variations of Extrahepatic Bile Ducts and Evaluation of the Length of Ducts Composing the Cystohepatic Triangle

Anatomic Variations of Extrahepatic Bile Ducts and Evaluation of the Length of Ducts Composing the Cystohepatic Triangle

Anatomical variations of the hepatobiliary system in Sudanese patients undergoing endoscopic retrograde cholangiopancreatography (ERCP)

Duplication of the Gallbladder Associated with Choledocal Cyst: A Case Report

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