Preoperative evaluation of accessory hepatic ducts by drip infusion cholangiography with CT

Hiromichi Ishii,Akinori Noguchi,Hiroyuki Tada,Naoki Tani,Riho Sugimoto,Hiroyuki Izumi,Masahide Yamaguchi,Tomoyuki Fukami,Hiroki Takeshita,Seiji Umehara,Tetsuro Yamane

doi:10.1186/s12893-017-0251-9

Abstract

BackgroundThis retrospective study aimed to investigate the incidence of each type of accessory hepatic duct by drip infusion cholangiography with CT (DIC-CT).MethodsFive hundred sixty nine patients who underwent preoperative DIC-CT and laparoscopic cholecystectomy were reviewed. Accessory hepatic ducts were classified as follows: type I (accessory hepatic ducts that merged with the common hepatic duct between the confluence of the right and left hepatic ducts and the cystic duct confluence), type II (those that merged with the common hepatic duct at the same site as the cystic duct), type III (those that merged with the common bile duct distal to the cystic duct confluence), type IV (the cystic duct merged with the accessory hepatic duct), and type V (accessory hepatic ducts that merged with the common hepatic or bile duct on the left side).ResultsAccessory hepatic ducts were observed in 50 patients. Type I, II, III, IV, and V accessory hepatic ducts were detected in 32, 3, 1, 11, and 3 patients, respectively. Based on their drainage areas, the accessory hepatic ducts were also classified as follows: a posterior branch in 22 patients, an anterior branch in 9 patients, a combination of posterior and anterior branches in 16 patients, a left-sided branch in 2 patients, and a caudate branch in 1 patient. None of the patients with accessory hepatic ducts suffered bile duct injuries.ConclusionThere are a number of variants of the accessory hepatic duct. DIC-CT is useful to detect the accessory hepatic duct.

Highlights

This retrospective study aimed to investigate the incidence of each type of accessory hepatic duct by drip infusion cholangiography with CT (DIC-CT)
Accessory hepatic ducts were classified according to the method described in previous reports [1]: type I, type II, type III, type IV, and type V
Of a total of 738 consecutive patients who underwent Laparoscopic cholecystectomy (LC), DIC-CT was performed in 569 patients, magnetic resonance cholangiopancreatography (MRCP) was conducted in 94 patients, endoscopic retrograde cholangiography was carried out in 34 patients, cholangiography was performed using a percutaneous transhepatic gallbladder drainage tube in 3 patients, and no examination of the biliary tree was conducted in 38 patients

Summary

Introduction

This retrospective study aimed to investigate the incidence of each type of accessory hepatic duct by drip infusion cholangiography with CT (DIC-CT). It is important to evaluate the anatomy of the biliary tree, It was reported that accessory hepatic ducts exhibit an incidence rate of 2–11% [1, 4,5,6,7]; there are few reports about the drainage areas of accessory hepatic ducts. The aims of this retrospective study are to investigate the incidence, type, and drainage area of accessory hepatic ducts using DIC-CT.

Methods

Results

Conclusion