Risk of Gallstone Formation in Aberrant Extrahepatic Biliary Tract Anatomy: A Review of Literature.

Ademola S Ojo,Alicia Pollard

doi:10.7759/cureus.10009

Abstract

The age-long mnemonic of '5Fs' (fat, female, fertile, forty, and fair) has traditionally been used in medical school instructions to describe the risk factors for gallstone disease. However, evidence suggests that aberrant extrahepatic biliary tract (EHBT) anatomy may contribute significantly to the risk of gallstone disease. This review explores the anatomy and embryological bases of EHBT variations as well as the prevalence of these variations. Also, we discuss the risk factors for gallstone formation in the relationship between gallstone disease and aberrant EHBT anatomy.

Highlights

BackgroundGallstone disease is one of the most common abnormalities of the gastrointestinal system with geographical variation in prevalence
Variations in extrahepatic biliary tract (EHBT) anatomy have been reported in imaging, cholecystectomy, endoscopic retrograde cholangiopancreatography, as well as autopsy studies which together account for a prevalence of 1.6% to 47.2% [12]
We review the risk factors for gallstone formation and the link between gallstone disease and aberrant EHBT anatomy

Summary

Introduction

Gallstone disease is one of the most common abnormalities of the gastrointestinal system with geographical variation in prevalence. This finding is similar to that of other studies that found a higher prevalence of choledocholithiasis in patients with separate channels compared to individuals with common channels [4,9] Another variation affecting the manner of entry is the uncommon anomaly of a DCBD. Mentioned studies reported low cystic duct, ectopic CBD opening, double CBD, separate CBD-pancreatic duct opening into the duodenum, and wide SCA as variations associated with an increased risk of gallstone formation. Individuals with abnormal CBD opening into the duodenum such as those with ectopic opening, double CBD, separate CBD-pancreatic duct entry may have associated sphincter of Oddi dysfunction, a factor which is associated with an increased risk of choledocholithiasis [46] These suggest multiple factors possibly play a role in increasing the risk of gallstone disease in individuals with aberrant EHBT anatomy

Conclusions

Disclosures

19. Alicioglu B

Findings

31. Flint ER