Abstract
Introduction: A detailed knowledge of normal branching pattern of intrahepatic bile duct and their variations is of utmost importance for any liver or biliary tract surgery to avoid severe post-surgery complications and morbidity. The objective of this study was to evaluate variations of intrahepatic bile ducts in Magnetic Resonance Cholangiopancreatography (MRCP) examinations in Nepalese population.Methods: This quantitative, cross sectional study was performed in patients referred for MRCP examinations for various clinical indications to Tribhuvan University Teaching Hospital, Maharajgunj, Nepal. Data were collected for a period of four months from August to November 2019 after IRB approval. Convenience sampling was employed and a total of 90 examinations were included. Data were obtained from the 1.5T Magnetom Amira Siemens MRI scanner. The 3D MRCP images were visually analyzed and classified into 7 Types according to the classification given by Choi et al.Results: In our study 47.8% patients had Type 1/normal IHBD (n=43). 20% had Type 2 (n=18), 3.3% had Type 3A (n=3), 5.6% had Type 3B. Type 5A (n=5), 7.8% had 5B (n=7), 3.3% had Type 6 (n=3) and 6.7% had Type 7 (n=6). No patients were found to have Type 3C and Type 4 IHBD variation. Among the total number of Type 1 cases, 67.44% (n=29) were female and rest were male.Conclusions: Typical IHBD was only found in a 47.8% patients and common other variations were also noted in our population. Type 2 and Type 5B were found in 20% and 7.8% patients respectively.
Highlights
A detailed knowledge of normal branching pattern of intrahepatic bile duct and their variations is of utmost importance for any liver or biliary tract surgery to avoid severe post-surgery complications and morbidity
Others were categorized as abnormal IHBD variations
Forty three patients among 90 selected for the study had Type 1 IHBD. This constituted 47.8% who had normal type of IHBD i.e. common hepatic duct is formed by fusion of the RHD and left hepatic duct (LHD)
Summary
A detailed knowledge of normal branching pattern of intrahepatic bile duct and their variations is of utmost importance for any liver or biliary tract surgery to avoid severe post-surgery complications and morbidity. The objective of this study was to evaluate variations of intrahepatic bile ducts in Magnetic Resonance Cholangiopancreatography (MRCP) examinations in Nepalese population. Normal biliary anatomy is seen in only 58% of the population.[1] Magnetic resonance cholangiopancreatography (MRCP) is an excellent non-invasive imaging technique. In our study we have used the classification given by Choi et al.[6] There is increasing number of case post cholecystectomy strictures, which is due to lack of prior knowledge of biliary duct anatomy. The objective of the study is to determine the percentage of population with the typical (Type 1) IHBD and atypical (Type 2 to 7) IHBD
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