The anatomical variations of the gall-bladder in relation to gender, body constitution type, according to results of topographical study

Abstract

This work presents the results of in a noninvasive topographic and anatomical study of the gallbladder and the anterior abdominal wall parameters in the right hypochondrium region (based on the results of spiral computed tomography and 3D modeling) in both sexes with different body types. It is established that there are some features of the gallbladder’s bottom and neck holotopia, depending on sex and body type of the patient. Extreme variants of the gallbladder’s position are revealed. The bottom of the gallbladder is located: a) the most lateral position in hyperstenic men; b) maximum medial in astenic women; c) maximum cranial in astenic men; d) the most caudal in astenic women. The gallbladder’s neck is located: a) the maximum lateral position in normostenic men; b) maximum medial in astenic women; c) maximum cranial in astenic men; c) the maximum caudal in astenic women. A mathematical algorithm is proposed and a software package is developed to determine the gollbladder’s bottom and neck probabilistic location in the three-dimensional coordinate system in patients depending on gender and body type. The developed technique allows to choose the type of operative access, to plan its individual localisation, and also to calculate criteria of operative access depending on patient’s anthropometric data during preparation for intervention. This allows to decide on the rationality of the use of a surgical access, choose its optimal location, the size of the skin incision, thereby reducing surgical trauma during the intervention and leads to improved quality of treatment of patients with gallstone disease.