Skip to main content
main-content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Erschienen in: European Surgery 5/2016

01.10.2016 | original article

Anatomic Variations of Biliary Ducts: Magnetic Resonance Cholangiopancreatography Findings of 1041 Consecutive Patients

Bile Ducts and MRCP

verfasst von: MD M. Adatepe, MD Z. H. Adibelli, MD O. S. Esen, MD C. Imamoglu, MD M. Yildirim, MD N. Erkan

Erschienen in: European Surgery | Ausgabe 5/2016

Einloggen, um Zugang zu erhalten
share
TEILEN

Abstract

Background

It is important for surgical purposes to know the biliary tract anatomy and its variations in detail. The aim of the study was to evaluate the frequency of anatomical variations of the biliary tract at hepatic bifurcation level and also at cystic duct level using magnetic resonance cholangiopancreatography (MRCP).

Methods

A total of 1041 patients (between 16 and 102 years of age, 600 women 441 men with mean age of 60.6) were included in the study. The MRCP imaging was carried out with a 1.5 Tesla magnetic resonance imaging (MRI) device by using heavily T2-weighted sequences.

Results

Among the 1041 patients included in the study, 424 (40.7 %) showed anatomical variations at different levels of the biliary tree, and 12 of these patients (1.15 %) had two anatomical variations. Typical anatomy was present in 57.2 % of the females and 62.1 % males. The highest incidence of variation at the level of bifurcation was trifurcation with 133 patients (12.8 %) and at the level of cystic duct was the medial cystic duct insertion with 56 patients (5.37 %).

Conclusions

Trifurcation and medial cystic duct insertion seem to be more frequent in females compared to males. It is necessary to have the knowledge of these variations to avoid possible complications and also help to achieve the most effective result. MRCP is a helpful and noninvasive technique of diagnosing bile duct variations; a preoperative description of these variations may prevent various surgical complications, and we recommend a routine preoperative MRCP especially before laparoscopic cholecystectomy, liver resection surgery and liver transplant surgery.
Literatur
1.
Zurück zum Zitat Mortele K, Ros PR. Anatomic variants of the biliary tree: MR cholangiographic findings and clinical applications. Am J Roentgenol. 2001;177:389–94. CrossRef Mortele K, Ros PR. Anatomic variants of the biliary tree: MR cholangiographic findings and clinical applications. Am J Roentgenol. 2001;177:389–94. CrossRef
2.
Zurück zum Zitat Mariolis-Sapsakos T, Kalles V, Papatheodorou K, Goutas N, Papapanagiotou I, Flessas I, Kaklamanos I, Arvanitis DL, Konstantinou E, Sgantzos MN. Anatomic variations of the right hepatic duct: results and surgical implications from a cadaveric study. Anat Res Int. 2012;2012:838179. PubMedPubMedCentral Mariolis-Sapsakos T, Kalles V, Papatheodorou K, Goutas N, Papapanagiotou I, Flessas I, Kaklamanos I, Arvanitis DL, Konstantinou E, Sgantzos MN. Anatomic variations of the right hepatic duct: results and surgical implications from a cadaveric study. Anat Res Int. 2012;2012:838179. PubMedPubMedCentral
3.
Zurück zum Zitat Cucchetti A, Peri E, Cescon M, Zanello M, Ercolani G, Zanfi C, Bertuzzo V, Di Gioia P, Pinna AD. Anatomic variations of intrahepatic bile ducts in a European series and meta-analysis of the literature. J Gastrointest Surg. 2011;15:623–30. CrossRefPubMed Cucchetti A, Peri E, Cescon M, Zanello M, Ercolani G, Zanfi C, Bertuzzo V, Di Gioia P, Pinna AD. Anatomic variations of intrahepatic bile ducts in a European series and meta-analysis of the literature. J Gastrointest Surg. 2011;15:623–30. CrossRefPubMed
4.
Zurück zum Zitat Onder H, Ozdemir MS, Tekbas G, Ekici F, Gümüs F, Bilici A. 3‑T MRI of the biliary tract variations. Surg Radiol Anat. 2013;35:161–7. CrossRefPubMed Onder H, Ozdemir MS, Tekbas G, Ekici F, Gümüs F, Bilici A. 3‑T MRI of the biliary tract variations. Surg Radiol Anat. 2013;35:161–7. CrossRefPubMed
5.
Zurück zum Zitat Uysal F, Obuz F, Uçar A, Seçil M, Igci E, Dicle O. Anatomic variations of the intrahepatic bile ducts: Analysis of magnetic resonance cholangiopancreatography in 1,011 consecutive patients. Digestion. 2014;89:194–200. CrossRefPubMed Uysal F, Obuz F, Uçar A, Seçil M, Igci E, Dicle O. Anatomic variations of the intrahepatic bile ducts: Analysis of magnetic resonance cholangiopancreatography in 1,011 consecutive patients. Digestion. 2014;89:194–200. CrossRefPubMed
6.
Zurück zum Zitat Zheng RQ, Chen GH, Xu EJ, et al. Evaluating biliary anatomy and variations in living liver donors by a new technique: three-dimensional contrast-enhanced ultrasonic cholangiography. Ultrasound Med Biol. 2010;36:1282–7. CrossRefPubMed Zheng RQ, Chen GH, Xu EJ, et al. Evaluating biliary anatomy and variations in living liver donors by a new technique: three-dimensional contrast-enhanced ultrasonic cholangiography. Ultrasound Med Biol. 2010;36:1282–7. CrossRefPubMed
7.
Zurück zum Zitat Tse F, Barkun JS, Romagnuolo J, Friedman G, Bornstein JD, Barkun AN. Nonoperative imaging techniques in suspected biliary tract obstruction. HPB (Oxford). 2006;8:409–25. CrossRef Tse F, Barkun JS, Romagnuolo J, Friedman G, Bornstein JD, Barkun AN. Nonoperative imaging techniques in suspected biliary tract obstruction. HPB (Oxford). 2006;8:409–25. CrossRef
8.
Zurück zum Zitat Ferrucci JTJR, Mueller PR, Harbin WP. Percutaneous transhepatic biliary drainage: technique, results, and applications. Radiology. 1980;135:1–13. CrossRefPubMed Ferrucci JTJR, Mueller PR, Harbin WP. Percutaneous transhepatic biliary drainage: technique, results, and applications. Radiology. 1980;135:1–13. CrossRefPubMed
9.
Zurück zum Zitat Cotton PB, Speer AG. Risks and benefits of percutaneous transhepatic biliary drainage. Gastroenterology. 1987;93:667–8. CrossRefPubMed Cotton PB, Speer AG. Risks and benefits of percutaneous transhepatic biliary drainage. Gastroenterology. 1987;93:667–8. CrossRefPubMed
11.
Zurück zum Zitat Stinton LM, Myers RP, Shaffer EA. Epidemiology of gallstones. Gastroenterol Clin North Am. 2010;39(2):157–69. CrossRefPubMed Stinton LM, Myers RP, Shaffer EA. Epidemiology of gallstones. Gastroenterol Clin North Am. 2010;39(2):157–69. CrossRefPubMed
12.
Zurück zum Zitat Salinas G, Velásquez C, Saavedra L, et al. Prevalence and risk factors for gallstone disease. Surg Laparosc Endosc Percutan Tech. 2004;14:250–3. CrossRefPubMed Salinas G, Velásquez C, Saavedra L, et al. Prevalence and risk factors for gallstone disease. Surg Laparosc Endosc Percutan Tech. 2004;14:250–3. CrossRefPubMed
13.
Zurück zum Zitat Karayalcin R, Genc V, Karaca AS, Ozaksıt G. Prevalence of cholelithiasis in a Turkish population sample of postmenopausal women. Turk J Gastroenterol. 2010;21(4):416–20. PubMed Karayalcin R, Genc V, Karaca AS, Ozaksıt G. Prevalence of cholelithiasis in a Turkish population sample of postmenopausal women. Turk J Gastroenterol. 2010;21(4):416–20. PubMed
14.
Zurück zum Zitat Strasberg SM. Avoidance of biliary injury during laparoscopic chelocystectomy. J Hepatobiliary Pancreat Surg. 2002;9:543–7. CrossRefPubMed Strasberg SM. Avoidance of biliary injury during laparoscopic chelocystectomy. J Hepatobiliary Pancreat Surg. 2002;9:543–7. CrossRefPubMed
16.
17.
Zurück zum Zitat Madani A, Watanabe Y, Feldman L, Vassilou MC, Barkun JS, Fried GM, Aggarwal R. Expert intraoperative judgment and decision-making: Defining the cognitive competencies for safe laparoscopic cholecystectomy. J Am Coll Surg. 2015;221:931–40. CrossRefPubMed Madani A, Watanabe Y, Feldman L, Vassilou MC, Barkun JS, Fried GM, Aggarwal R. Expert intraoperative judgment and decision-making: Defining the cognitive competencies for safe laparoscopic cholecystectomy. J Am Coll Surg. 2015;221:931–40. CrossRefPubMed
18.
Zurück zum Zitat Nakamura T, Tanaka K, Kiuchi T, Kasahara M, Oike F, Ueda M, Kaihara S, Egawa H, Ozden I, Kobayashi N, Uemoto S. Anatomical variations and surgical strategies in right lobe living donor liver transplantation: lessons from 120 cases. Transplantation. 2002;73:1896–903. CrossRefPubMed Nakamura T, Tanaka K, Kiuchi T, Kasahara M, Oike F, Ueda M, Kaihara S, Egawa H, Ozden I, Kobayashi N, Uemoto S. Anatomical variations and surgical strategies in right lobe living donor liver transplantation: lessons from 120 cases. Transplantation. 2002;73:1896–903. CrossRefPubMed
19.
Zurück zum Zitat Vidal V, Hardwigsen J, Jacquier A, Le Corroller T, Gaubert JY, Moulin G, Bartoli JM, Petit P, Champsaur P. Anatomic variants of the biliary tree with MR cholangiography: feasibility and surgical applications. J Chir (Paris). 2007;144:505–7. CrossRef Vidal V, Hardwigsen J, Jacquier A, Le Corroller T, Gaubert JY, Moulin G, Bartoli JM, Petit P, Champsaur P. Anatomic variants of the biliary tree with MR cholangiography: feasibility and surgical applications. J Chir (Paris). 2007;144:505–7. CrossRef
20.
Zurück zum Zitat Sirvanci M, Duran C, Ozturk E, Balci D, Dayangac M, Onat L, Yuzer Y, Tokat Y, Killi R. The value of magnetic resonance cholangiography in the preoperative assessment of living liver donors. Clin Imaging. 2007;31:401–5. CrossRefPubMed Sirvanci M, Duran C, Ozturk E, Balci D, Dayangac M, Onat L, Yuzer Y, Tokat Y, Killi R. The value of magnetic resonance cholangiography in the preoperative assessment of living liver donors. Clin Imaging. 2007;31:401–5. CrossRefPubMed
21.
Zurück zum Zitat Karakas HM, Celik T, Alicioglu B. Bile duct anatomy of the Anatolian Caucasian population: Huang classification revisited. Surg Radiol Anat. 2008;30:539–45. CrossRefPubMed Karakas HM, Celik T, Alicioglu B. Bile duct anatomy of the Anatolian Caucasian population: Huang classification revisited. Surg Radiol Anat. 2008;30:539–45. CrossRefPubMed
Metadaten
Titel
Anatomic Variations of Biliary Ducts: Magnetic Resonance Cholangiopancreatography Findings of 1041 Consecutive Patients
Bile Ducts and MRCP
verfasst von
MD M. Adatepe
MD Z. H. Adibelli
MD O. S. Esen
MD C. Imamoglu
MD M. Yildirim
MD N. Erkan
Publikationsdatum
01.10.2016
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 5/2016
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-016-0393-5