Surgical anatomy of sub-hepatic biliary system

Abstract

IntroductionThe anatomy of liver and extra-hepatic biliary apparatus has always been the focus of attention among anatomists and surgeons. It has gained greater significance in the recent years in view of technical refinements in the field of cholecystectomy, hepatic surgery and transplantation. Present study emphasizes the normal as well as variations of extra-hepatic biliary apparatus, as most of the published work on the surgical anatomy of the extra-hepatic biliary apparatus refers various ethnic groups variations. Literature on this topic in western U.P. subjects is scanty. MethodA study was conducted on 59 individuals undergoing hepatobiliary surgery after informed consent in the Department of Surgery and on 30 cadavers in the Department of Anatomy, LLRM Medical College Meerut, and Saraswathi Institute of Medical Sciences, Hapur during September 2004 to May 2011. ResultThe study revealed that in all cases, the union of hepatic ducts was extra-hepatic, of which 10% were angular low union and 5% parallel low union. In 95% cases cystic duct had angular union and 4% had parallel type of union with common hepatic duct and in one case cystic duct united with accessory hepatic duct. 16% cases had short cystic duct i.e. 1–2 cm in length. 94% cases show usual relation in hepatoduodenal ligament and in 6% common bile duct was to the left of hepatic artery. DiscussionThe obtained results presented variations regarding certain parameters when compared to previous studies and they represent the ethnic parameters of western UP.