Intrahepatic Transposition of Bile Ducts

Jasmin Delić,Eldar Isaković,Amir Denjalić,Admedina Savković,Sergije Marković,Alma Bajtarević

doi:10.5402/2012/283527

Abstract

Objective. To describe the intrahepatic bile duct transposition (anatomical variation occurring in intrahepatic ducts) and to determine the frequency of this variation. Material and Methods. The researches were performed randomly on 100 livers of adults, both sexes. Main research methods were anatomical macrodissection. As a criterion for determination of variations in some parts of bile tree, we used the classification of Segmentatio hepatis according to Couinaud (1957) according to Terminologia Anatomica, Thieme Stuugart: Federative Committee on Anatomical Terminology, 1988. Results. Intrahepatic transposition of bile ducts was found in two cases (2%), out of total examined cases (100): right-left transposition (right segmental bile duct, originating from the segment VIII, joins the left liver duct-ductus hepaticus sinister) and left-right intrahepatic transposition (left segmental bile duct originating from the segment IV ends in right liver duct-ductus hepaticus dexter). Conclusion. Safety and success in liver transplantation to great extent depends on knowledge of anatomy and some common embryological anomalies in bile tree. Variations in bile tree were found in 24–43% of cases, out of which 1–22% are the variations of intrahepatic bile ducts. Therefore, good knowledge on ductal anatomy enables good planning, safe performance of therapeutic and operative procedures, and decreases the risk of intraoperative and postoperative complications.

Highlights

Biliary drainage has long been called Achilles heel liver transplantion, and biliary complications compromise the succese of liver transplantation [1]
Intrahepatic transposition of bile ducts is manifested by the fact that bile ducts originating from the right liver lobe may end in the left liver duct; that is, bile ducts of the left liver lobe may end in the right liver duct
In one case we found right-left intrahepatic transposition, where the right segmental bile duct (RSBD), originating from the segment VIII, joins the left liver duct (LLD)

Summary

Objective

To describe the intrahepatic bile duct transposition (anatomical variation occurring in intrahepatic ducts) and to determine the frequency of this variation. The researches were performed randomly on 100 livers of adults, both sexes. As a criterion for determination of variations in some parts of bile tree, we used the classification of Segmentatio hepatis according to Couinaud (1957) according to Terminologia Anatomica, Thieme Stuugart: Federative Committee on Anatomical Terminology, 1988. Safety and success in liver transplantation to great extent depends on knowledge of anatomy and some common embryological anomalies in bile tree. Variations in bile tree were found in 24–43% of cases, out of which 1–22% are the variations of intrahepatic bile ducts. Good knowledge on ductal anatomy enables good planning, safe performance of therapeutic and operative procedures, and decreases the risk of intraoperative and postoperative complications

Introduction

Material and Methods

Results

Discussion

Conclusion