Abstract
BackgroundTo determine the most common abnormal anatomical variations of extra-hepatic biliary tract (EHBT), and their relation to biliary tract injuries and stones formation.MethodsThis is a retrospective review of 120 patients, who underwent endoscopic retrograde cholangiopancreaticography (ERCP) and/or magnetic resonance cholangiopancreaticography (MRCP), between July 2011 and June 2013. The patients’ ERCP and MRCP images were reviewed and evaluated for the anatomy of EHBT; the medical records were reviewed for demographic data, biliary tracts injuries and stones formation.ResultsOut of 120 patients, 50 were males (41.7%) and 70 were females (58.3%). The mean age was 54 years old (range 20 - 88). Abnormal anatomy was reported in 30% (n = 36). Short cystic duct (CD) was found in 20% (n = 24), left CD insertion in 5% (n = 6), CD inserted into the right hepatic duct (RHD) in 1.7% (n = 2), duct of Luschka in 3.33% (n = 4) and accessory hepatic duct in also 3.33% (n = 4). Biliary tract injuries were reported in 15% (n = 18) and stones in 71.7% (n = 86). Biliary tract injuries were higher in abnormal anatomy (P = 0.04), but there was no relation between abnormal anatomy and stones formation.ConclusionAbnormal anatomy of EHBT was found to be 30%. The most common abnormality is short CD followed by left CD insertion. Surgeons should be aware of these common abnormalities in our patients, hence avoiding injuries to the biliary tract during surgery. The abnormal anatomy was associated with high incidence of biliary tract injury but has no relation to biliary stone formation.
Highlights
Extra-hepatic biliary tract (EHBT) is one of the most common sites of surgical procedures
It is important for the surgeon to be aware of the extra-hepatic biliary tract (EHBT) anatomy and be able to identify its possible abnormal anatomical variations, as the presence of these variations may increase the likelihood of biliary tract injuries during surgery [1, 2]
We found no relation between Common bile duct (CBD) length and gender (P = 0.1); there was positive correlation between
Summary
Extra-hepatic biliary tract (EHBT) is one of the most common sites of surgical procedures. It is important for the surgeon to be aware of the EHBT anatomy and be able to identify its possible abnormal anatomical variations, as the presence of these variations may increase the likelihood of biliary tract injuries during surgery [1, 2]. Incidence of EHBT anatomical variations was reported to be as much as 47% [1]. The aim of this study is to determine the most common abnormal anatomical variations of EHBT, and their relation to biliary tract injuries and stones formation, making surgeons aware of the common abnormalities, avoiding biliary tract injury during surgery. To determine the most common abnormal anatomical variations of extra-hepatic biliary tract (EHBT), and their relation to biliary tract injuries and stones formation
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