scholarly journals Anomalous anatomical variation in extrahepatic biliary tree and pancreas and its related vessels: a cadaveric study

2019 ◽  
Vol 6 (9) ◽  
pp. 3111
Author(s):  
Mahim Koshariya ◽  
Sheikh Behram ◽  
Jay Prakash Singour ◽  
Shashikant Tiwari ◽  
Vidhu Khare
Keyword(s):  
Cystic Duct ◽  
Hepatic Duct ◽  
Anatomical Variation ◽  
Clinical Importance ◽  
Biliary Tree ◽  
Cystic Artery ◽  
Common Hepatic Duct ◽  
Left Hepatic Duct ◽  
Extrahepatic Biliary Tree ◽  
Insight Into

Background: Congenital anamolies of extrahepatic biliary apparatus and pancreas have long been recognized and are of clinical importance because when present may surprise the surgeon during surgery and lead to iatrogenic injuries. Surgeries on extra-hepatic biliary apparatus and pancreas are regularly performed throughout the world. Thus insight into the normal anatomy and congenital variations will reduce complication and definitely improve outcome.Methods: Study was conducted in department of surgery GMC Bhopal and dissection was carried out in Department of Forensic Medicine on 100 cadavers with approval from ethical committee.Results: In 100 cases 70 were male and 30 female. The most common variation in extra hepatic biliary apparatus was short cystic duct was found in 6% cases then formation of common hepatic duct by union of right hepatic duct and left hepatic duct was intrahepatic in 3% cases. There was low insertion of cystic duct with common hepatic duct in 1% case. Cystic artery originating from left hepatic artery in 1% case, in 1% case cystic artery was anterior to common hepatic duct. In Pancreas anterior arterial arcade was absent in 2% cases and its origin varied in 2% case. Posterior pancreatic arcade absent in 1% cases and variation in origin was present in 1% case. The variation in pancreatic duct course was present in 22% cases.Conclusions: Thus significant variation was seen and it could definitely be helpful to hepatobiliary, laproscopic surgeons, radiologist and will further contribute to literature on variation of extrahepatic biliary apparatus and pancreas and its related vessels.

scholarly journals Comparative Anatomical, Ultrasonographical and Radiological studies of the biliary system of Rabbits and Domestic cats in Egypt

2019 ◽  
Author(s):  
R.T. Reem ◽  
M.A. Maher ◽  
H.E. Alaa ◽  
H.A. Farghali
Keyword(s):  
Bile Duct ◽  
Gall Bladder ◽  
Cystic Duct ◽  
Hepatic Duct ◽  
Human Model ◽  
Common Hepatic Duct ◽  
Domestic Cats ◽  
Left Hepatic Duct ◽  
Right Lobe ◽  
The Right

ABSTRACTUnder the prevailing overall Conditions of all veterinarians for the diagnosis of biliary diseases, application of surgical procedures and liver transplantation in Cats as carnivorous pet animal, and Rabbits as herbivorous pet animal and also as a human model in research. The present study was constructed on twelve native breeds of rabbits (Oryctolagus cuniculus) and eighteen adult domestic cats (Felis catus domesticus). We concluded that, in brief; the rabbit gall bladder was relatively small, fixed by several small hepato-cystic ducts to its fossa. The rabbit bile duct was formed commonly by the junction of the left hepatic duct and the cystic duct. The cystic duct was commonly fairly large, received the right hepatic duct that collected the right lobe in its route to enter the duodenum, the bile duct receives the branch of the caudate process of the caudate lobe. The present study revealed other four anatomic variations dealing with the shape and size of the feline native breed’s gall bladder from fundic duplication, bilobed, truncated fundus and distended rounded fundus. Commonly, the bile duct was formed by the triple convergence of the left and the right hepatic ducts with the cystic duct. However, in some exceptional cases a short common hepatic duct was formed. Sonographically, the normal gall bladder in rabbit appeared small, elongated with anechoic lumen bordered by right lobe laterally and quadrate lobe medially and has no visible wall, but in cat varied in conformation, bordered by the right medial lobe laterally and the quadrate lobe medially surrounded by echogenic wall.

scholarly journals Metastatic Neoplasms of the Large Bile Ducts- A Clinicopathological Study

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S58-S58
Author(s):  
A Verma ◽  
I Nalbantoglu ◽  
A Barbieri
Keyword(s):  
Gastrointestinal Tract ◽  
Bile Duct ◽  
Hepatic Duct ◽  
Biliary Tree ◽  
Primary Site ◽  
Primary Adenocarcinoma ◽  
Common Hepatic Duct ◽  
Biliary Strictures ◽  
Left Hepatic Duct ◽  
Treatment Considerations

Abstract Introduction/Objective Biliary strictures are often considered malignant until proven otherwise. While the majority of malignant biliary strictures represent a primary neoplasm, secondary involvement by metastasis also rarely occurs. Primary cholangiocarcinoma and metastatic disease have different treatment considerations and likely different prognoses. The aim of this study is to look at the clinico-pathological characteristics of metastatic neoplasms of the bile duct. Methods/Case Report We retrospectively searched the pathology archives for biliary biopsies between 1991-2020. Patients with primary biliary, gallbladder, pancreatic, ampullary and hepatic malignancies and all cases of lymphoma were excluded from the study. A total of 20 cases were included. Results (if a Case Study enter NA) The median age of the patients was 63 years with a M:F ratio of 1.9:1. The biopsies were taken from the common bile duct (n=17), common hepatic duct (n=2) and left hepatic duct (n=1). 8 patients had synchronous and 12 had metachronous presentation. The overall median interval between the bile duct metastasis and primary was 18 months (Range: 0-100 months) for all patients and 33 months for metachronous cases. For 13 tumors, the primary site of origin was in the gastrointestinal tract (colon: 7; stomach: 4; anal canal: 1; gastro-esophageal junction: 1). Other primary sites included breast (3 cases), lung, endometrium and adrenal (1 each). One case presented with metastatic melanoma with an occult primary. Adenocarcinoma was the most common histological subtype seen in 17 cases. Other histological subtypes were squamous cell carcinoma, adrenocortical carcinoma and melanoma. Conclusion Secondary involvement of the bile duct by metastasis is rare. Most cases are metastasis from the lumenal gastrointestinal tract, with colon being the most common primary site. They are more likely to have a metachronous presentation with rare instances of bile duct metastasis as the first presentation. Awareness of secondary involvement of the biliary tree by metastasis is important as they can have prognostic and therapeutic significance.

scholarly journals Granular cell tumor of the common hepatic duct presenting as cholangiocarcinoma and acute acalculous cholecystitis

2008 ◽  
Vol 55 (4) ◽  
pp. 99-101 ◽  
Author(s):  
D. Bilanovic ◽  
I. Boricic ◽  
D. Zdravkovic ◽  
T. Randjelovic ◽  
N. Stanisavljevic ◽  
...  
Keyword(s):  
Granular Cell Tumor ◽  
Hepatic Duct ◽  
Acalculous Cholecystitis ◽  
Granular Cell ◽  
Biliary Tree ◽  
Cell Tumor ◽  
Common Hepatic Duct ◽  
Benign Tumors ◽  
Acute Acalculous Cholecystitis ◽  
Extrahepatic Biliary Tree

Granular cell tumors (GCT) are rare benign tumors. Less than 1% of GCTs involve the extrahepatic biliary tree. Most researches favor a Schwann cell origin. Patient, caucasion, female, 31 year old presented with 4 month history of painless jaundice and pruritus. US and CT revealed dilatation of intrahepatic biliary tree and surgery was performed. Firm tumor mass was found above the conjunction of cystic duct and common hepatic duct (CHD) that caused obstruction and gallblader empyema. The patient underwent radical surgical procedure because Klatskin tumor was clinically suspected. Patohystology and immunohistochemistry confirmed granular cell tumor. Eight years after surgery the patient is wellbeing without symptoms. To our knowledge 69 cases of GCT of the extrahepatic biliary tree have been reported and none of the acute acalculous cholecystitis case accompanied by GCT of CHD. Granular cell tumors are rarely diagnosed preoperatively. Wide resection offers the best chance for cure.

scholarly journals Presence of Cystic Artery in the Calot’s Triangle and Its Relation with Common Hepatic Duct – a Postmortem Study

2013 ◽  
Vol 10 (2) ◽  
pp. 50-56
Author(s):  
Md Khalilur Rahman ◽  
Selina Anwar
Keyword(s):  
Surgical Intervention ◽  
Hepatic Duct ◽  
Biliary Tree ◽  
Cystic Artery ◽  
Common Hepatic Duct ◽  
Common Disease ◽  
Medicine Department ◽  
Medical College ◽  
Iatrogenic Complications ◽  
The Common

Introduction: Most common disease of liver and biliary tree is cholelithiasis which needs surgical intervention. Safe execution of traditional cholecystectomy or laparoscopic surgery needs proper knowledge of the origin, course, branching pattern of the cystic artery and its relation with common hepatic duct. This study was aimed to find the presence of cystic artery in the Calot’s triangle and its relation with common hepatic duct to prevent any iatrogenic complications especially for newer surgeons in this field. Materials and Methods: This study was done on 60 postmortem gallbladder collected from postmortem dead bodies under the guidance of Forensic Medicine department of Rangpur Medical College, Rangpur. After collection of the specimen, the boundary of the Calot’ triangle was identified and course of the cystic artery was observed whether it was passing through the triangle or not. The relation of the cystic artery with the common hepatic duct was also noticed. Results: It was found from the result of the present study that out of 60 cases cystic artery was found as a content of Calot’s triangle in 58 (96.65%) cases. Regarding the relations of the cystic artery, out of 60 specimens, in 54 cases (90%) cystic arteries were observed to pass behind the common hepatic duct. In four cases (6.67%) cystic artery were found crossing over the common hepatic duct and in two cases (3.33%), cystic artery were found crossing below the cystic duct. In one cases, branches of cystic artery (superficial and deep branch) was found. In every specimen a Calot‘s node was found within the Calot‘s triangle. Discussions: The result of the present study was compared with other workers. Though many of the workers found similar results regarding the course of the cystic artery through the Calot’ triangle but some workers found higher number of cystic artery passing outside the triangle. Also higher percentage of cystic artery passing over the common hepatic duct was found by many workers than the present study. DOI: http://dx.doi.org/10.3329/bja.v10i2.17282 Bangladesh Journal of Anatomy, July 2012, Vol. 10 No. 2 pp 50-56

scholarly journals Left Sided Gallbladder - Case Report

2016 ◽  
Vol 62 (3) ◽  
pp. 376-377
Author(s):  
Török Árpád ◽  
Kantor Tibor ◽  
Borz Cristian ◽  
Márton István Dénes ◽  
Mureșan Mircea
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Case Report ◽  
Cystic Duct ◽  
Hepatic Duct ◽  
Gallstone Disease ◽  
Cystic Artery ◽  
Common Hepatic Duct ◽  
Consecutive Series ◽  
The Common ◽  
Abnormal Anatomy

AbstractLeft sided gallbladder is a rare anomaly that is often associated with other abnormal anatomy in the hepatobiliary system. One left positioned gallbladder was found in a consecutive series of 3290 patients undergoing laparoscopic cholecystectomy for gallstone disease in the Mure County Emergency Hospital’s 2nd Surgery Clinic between 2005 and 2015, a prevalence of 0.03 per cent. In case of left sided gallbladder the cystic artery always crosses in front of the common bile duct from right to left. The cystic duct may open on the left or right side of the common hepatic duct. Anterograde cholecystectomy is the best choice for precise exploration of the cystic duct and cystic artery.

scholarly journals Anatomic Variations of the Right Hepatic Duct: Results and Surgical Implications From a Cadaveric Study

2019 ◽  
Vol 17 (01) ◽  
pp. 90-93
Author(s):  
Akinchan Kafle ◽  
Bidur Adhikari ◽  
Rajani Shrestha ◽  
Nirju Ranjit
Keyword(s):  
Hepatic Duct ◽  
Clinical Importance ◽  
Left Lobe ◽  
Common Hepatic Duct ◽  
Blue Dye ◽  
Left Hepatic Duct ◽  
Cross Sectional ◽  
Bile Duct Wall ◽  
Split Liver ◽  
The Right

Background: Right hepatic duct, formed by the confluence of the anterior and posterior right sectorial ducts, joins left hepatic duct to form common hepatic duct. This fashion of confluence does not prevail in all cases. The sectorial ducts can aberrantly meet left duct and rest of the ducts from the left lobe of liver. Presence of such variation imposes clinical importance during peri-hilar, split liver transplant surgery or cholecystectomy. Nepalese population has not been explored before disregarding clinical necessity as MRI or cholangiography. Methods: Descriptive cross sectional study was conducted in 107 cases dissecting the main portal fissure separating hemi liver and extrahepatic biliary confluences. Methylene blue dye was injected and bile duct wall was cut open to the study pattern of the confluence. Data analysis was done with Statistical Package for Social Sciences (SPSS) version 17.Results: Normal variant of confluence was found in 72% cases, aberrant right posterior sectorial duct joins left hepatic duct in 9.3% and aberrant right anterior duct or low insertion of the right posterior sectorial duct was found in 1.9%. 9.3% of cases there is no true right hepatic duct often described as triple confluence. 0.9% cases showed no particular pattern of confluence where common hepatic duct is formed by multiple confluence. Quadrate lobe was found to be draining into right anterior sectorial duct in a single case.Conclusions: Right hepatic duct confluence pattern is variable and all the evidence occurs at the main portal fissure. Right sectorial duct may join the left duct avoiding normal confluence pattern. Right posterior sectorial duct may be inserted low in the common bile duct.Keywords: Duct; hepatic; sectorial; variation.

Low Insertion of the Cystic Duct in the Common Hepatic Duct as a Coincidence with an Onset of a Pancreatic Cephalic Carcinoma

2015 ◽  
Vol 69 (2) ◽  
pp. 94-99
Author(s):  
Aleksandar Sumkovski ◽  
Stojan Gjosev ◽  
Ljubomir Ognjenovikj ◽  
Meri Trajkovska ◽  
Goce Spasovski
Keyword(s):  
Cystic Duct ◽  
Surgical Procedure ◽  
Average Length ◽  
Hepatic Duct ◽  
Biliary Tree ◽  
Whipple Procedure ◽  
Common Hepatic Duct ◽  
Observation Study ◽  
Long Time ◽  
The Common

AbstractIntroduction. The normal anatomy of the cystic duct (CD) has been described a long time ago, but the basic description is valid up today: average length 2-4 mm, caliber 1-1.5 mm, and reduced volume by the spiral mu­­cous folds of Heister. Anatomic variants of the CD and its aberrant insertion lead to confusion during pre­opera­tive imaging examinations, and particularly to un­­pleasant situation during surgery, when the surgeon has to confirm positive identification of the anatomical struc­tures, in order to avoid iatrogenic biliary lesion. The aim of this prospective observation study was to evaluate the eventual bond between the low insertion of the CD in the common hepatic duct (CHD) and the onset of the pan­creatic cephalic carcinoma (PCC).Methods. In this study we examined 21 patients with PCC. The inclusion criteria was diagnosed PCC in ope­rable stage. The method for estimation of both, the ope­ra­bility and the site of insertion of the CD into CHD cons­isted of: ultrasonography (US), endoscopic retrograde cholangiopancreatography (ERCP), CT and MRI. Finally, the surgical procedure was extensive duodenopan­cre­a­tectomy, Whipple procedure. The surgical procedure was supplemented with periarterectomy and bilateral coeliac ganglienectomy in purpose of radical treat­ment and denervation.Results. Of the total of 21 patients, we revealed low in­sertion of the CD (LICD) in 6 patients (28%). In 4 pa­tients (3 male and 1 female), the LICD was presented with complete dilatation of the biliary tree, including CD, CHD and the gallbladder, while in 2 patients the CD and its low insertion were absent on the images-ERCP, CT. In these 2 patients the appearance was amid the cranial infiltration and growth of the carcinoma.Conclusions. Comparison with other reference radiolo­gical and anatomical studies, our results significantly di­ffer in the frequency of the appearance of the LICD. This may partially be due to different definitions and criteria referring to LICD. On the other hand, the observed diffe­rences may be caused by the eventually present connec­tion between the LICD and PCC. Therefore, further stu­dies with a larger number of participants are necessary (anatomical, pathological and genetic), to confirm or to deny the predicted bond between the LICD and PCC.

ANATOMIC VARIANTS OF INTRAHEPATIC BILE DUCTS AND CYSTIC DUCTS IN SAUDI ARABIA: MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY ANALYSIS IN LIVER DONORS

2021 ◽  
pp. 30-32
Author(s):  
Ayesha Nuzhat ◽  
Maram AlGhamdi ◽  
Abdullah AlAyed
Keyword(s):  
Saudi Arabia ◽  
Bile Duct ◽  
Magnetic Resonance ◽  
Cystic Duct ◽  
Hepatic Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Radiology Department ◽  
Common Hepatic Duct ◽  
Left Hepatic Duct ◽  
Liver Donors

Background: Data regarding the pattern of the anatomical variations of biliary tree from the Middle East is considerably decient when compared with the literature available elsewhere. To dete Objective: rmine anatomic variation in branching pattern of intra hepatic bile duct and cystic duct on Magnetic resonance Cholangiopancreatography in liver donors from Saudi Arabia. Methods: This descriptive study was done at Radiology Department Prince Sultan Military Medical City Riyadh, KSA between 2019-2020 after taking IRB approval (IRB No:1404) and collecting data of liver donors (n=92) using Magnetic resonance cholangiopancreatography. Result: Regarding the right hepatic duct, in our study Type A1(69.6%) was predominant followed by Type A2(16.3%). As for the left hepatic duct, typical pattern Type A was observed in 94.6% cases. Drainage of right posterior hepatic duct into left hepatic duct, A3(7.6%) and A4(5.4%) drainage of right posterior hepatic duct into the common hepatic duct were the most common variants in our study. Accessory bile duct with segment 5 draining into CHD with segment 5and 8 draining into CHD was found in 2.2% of cases, and an aberrant bile duct in 1.1% In our study, majority (97.8% )had lateral insertion of cystic duct and in 1.4% accessory cystic duct was noted. Because of growing trend found in Conclusion: number of liver transplant surgeries being performed, magnetic resonance cholangiopancreatography (MRCP) has become optimal for noninvasive evaluation of abnormalities of the biliary tract.

A CADAVERIC STUDY ON VARIATIONS OF THE COMMON HEPATIC DUCT

2021 ◽  
pp. 19-21
Author(s):  
Sabeersha. S
Keyword(s):  
Postoperative Complications ◽  
Hepatic Duct ◽  
Biliary Tree ◽  
Descriptive Study ◽  
Common Hepatic Duct ◽  
Clinical Implications ◽  
Normal Anatomy ◽  
Anatomical Knowledge ◽  
The Common ◽  
Extrahepatic Biliary Tree

Variations in the anatomy of extrahepatic biliary apparatus (EHBA) has been a subject of extended research due to its clinical implications. Cholecystectomy is the commonly performed abdominal surgeries and its safety requires the adequate appreciation of anatomical abnormalities of the extrahepatic biliary tree to decrease the morbidity and mortality of the surgery. Abnormalities of the major ducts and presence of accessory ducts give rise to preoperative difculties and postoperative complications. Background & objectives: To study the normal anatomy of common hepatic duct and its variations. With the Methods: aim of the above study, a prospective descriptive study was conducted on 55 specimens with reference to the ducts. Different parameters were used as union of right and left hepatic ducts and common hepatic duct measurements and looked for variations such as accessory hepatic ducts. Results & discussion: Extrahepatic union of right and left hepatic ducts seen in 98% cases and intrahepatic union in 2%. Length of common hepatic duct varied from 1.5 to 4.7 cm with an average of 2.9cm. Accessory hepatic ducts were seen in 7 cases (13%) in which 2 joined the common hepatic duct, 1 joined LHD and 3 were to the cystic duct. All the ndings of the ducts are to enlighte Conclusions: n the anatomical knowledge of the anatomists, general and laparoscopic surgeons, oncosurgeons and to the transplant surgeons which are abundantly useful.

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