Skip to main content
SpringerLink
Log in

Congenital anatomical abnormalities of the extrahepatic biliary duct: a personal audit

Anomalies congénitales des voies biliaires extra-hépatiques : évaluation d'une expérience

  • Original Articles
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Summary

Awareness of variations in the anatomy of extrahepatic bile ducts may be important in preventing iatrogenic injury to the duct system during cholecystectomy. Their delineation, before or during surgery is therefore considered mandatory in this surgical unit, and a policy of always performing a per-operative cholangiogram has allowed us to evaluate the duct system in a retrospective review of 2080 cases. Twelve surgically significant anatomical variations were found, consisting of absent cystic duct (three cases), abnormal termination of cystic duct (two into the right hepatic duct, and one into the left hepatic duct), one case of double cystic duct, and five cases of significant accessory bile ducts.

Résumé

La connaissance des variations anatomiques des voies biliaires extra-hépatiques est un élément important pour la prévention des plaies biliaires iatrogènes au cours de la cholecystectomie. Leur recherche systématique préopératoire ou peropératoire est donc exigée dans notre pratique chirurgicale et le recours systématique à une cholangiographie per-opératoire a permis d'étudier les variations des canaux biliaires dans une étude rétrospective de 2080 cas. Douze types de variations canalaires avec incidence chirurgicale ont été découverts : l'absence de conduit cystique (trois cas), la terminaison anormale du conduit cystique (deux fois dans le canal hépatique droit, une fois dans le canal hépatique gauche), un cas de dédoublement du conduit cystique et cinq cas de canaux biliaires accessoires.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Adam Y, Metcalf W (1966) Absence of the cystic duct: a case report, the embryology and a review of the literature. Ann Surg 164: 1056–1058

    Google Scholar 

  2. Albaret P, Chevalier JM, Cronier P, Enon B, Moreau P, Pillet J (1981) Accessory hepatic ducts opening into the gallbladder or cystic ducts. Ann Chir 35: 88–92

    Google Scholar 

  3. Allan S, Hurrell TA (1974) Agenesis of the gallbladder and cystic duct: a report of 3 cases. Br J Surg 61: 145–146

    Google Scholar 

  4. Atlas H, Jacquemin JP (1972) Rare abnormality of the extrahepatic bile ducts. Accessory hepatic duct opening into the middle of Wirsung's duct. J Chir (Paris) 104: 591–594

    Google Scholar 

  5. Auld CD (1985) The common bile duct and its anomalies. J R Coll Surg Edinb 30: 248–250

    Google Scholar 

  6. Benson EA, Page RE (1976) A practical reappraisal of the anatomy of the extrahepatic bile ducts and arteries. Br J Surg 63: 853–860

    Google Scholar 

  7. Bercy G (1992) Biliary duct anatomy and anomalies. The role of intraoperative cholangiography during laparoscopic cholecystectomy. Surg Clin North Am 72: 1069–1075

    Google Scholar 

  8. Bogardus GM, Lundmark VO (1969) The short or absent cystic duct. Surgery 65: 274–275

    Google Scholar 

  9. Boyden EA (1944) Congenital variations of the extrahepatic biliary tract: a review. Minn Med 27: 932

    Google Scholar 

  10. Bouchet Y, Passagia JG, Lopez JF. Anatomie des voies biliaires extra-hepatiques. Editions Techniques — Encycl Med Chir (Paris, France), Techniques Chirurgicales, Appareil Digestif, 40900, 10–1990

  11. Brandt CP, Eckhauser ML (1994) Rare bile duct anomalies. A case report and implications for laparoscopic cholecystectomy. Surg Endosc 8: 329–331

    Google Scholar 

  12. Champetier J, Letoublon C, Anaasan I, Charvin B (1991) The cystohepatic ducts: surgical implications. Surg Radiol Anat 13: 203–211

    Google Scholar 

  13. Champetier J, Letoublon C, Arvieux C, Gerard P, Labrosse PA (1989) Variations of division of the extrahepatic bile ducts: significance and origin, surgical implications. J Chir 126: 147–154

    Google Scholar 

  14. Charels K, Kloppel G (1989) The bile duct system and its anatomical variations. Endoscopy 21 Suppl 1: 300–308

    Google Scholar 

  15. Dia A, Venditelli F, Valleix D, Descottes B (1989) Le canal cystique double. A propos d'un cas. Ann Chir 43: 306–308

    Google Scholar 

  16. Foster JH, Wayson EE (1962) Surgical significance of aberrant bile ducts. Amer J Surg 104: 14

    Google Scholar 

  17. Fujita N, Shirai Y, Ohtani T, Tsukada K, Hirota M, Hatakeyama K (1996) Junction of the cystic duct with the left hepatic duct: report of a case discovered during laparoscopic cholecystectomy. Surg Laparosc Endosc 6: 445–447

    Google Scholar 

  18. Gouma DJ, Go PM (1994) Bile duct injury during laparoscopic and conventional cholecystectomy. J Am Coll Surg 178: 229–233

    Google Scholar 

  19. Gross RE (1936) Congenital anomalies of the gallbladder. A review of 148 cases, with report of double gallbladder. Arch Surg 32: 131–162

    Google Scholar 

  20. Healey JE, Schroy PC (1953) Anatomy of the bile ducts within the human liver. Arch Surg 66: 599–616

    Google Scholar 

  21. Heloury Y, Leborgne J, Roger JM, Robert R, Lehur PA, Pannier M, Barbin JY (1985) Radiological anatomy of the bile ducts based on intraoperative investigation in 250 cases. Anat Clin 7: 93–102

    Google Scholar 

  22. Hirono Y, Takita Y, Nitta N, Hashimoto H (1997) Double cystic duct found by intraoperative cholangiography in laparoscopic cholecytectomy. Surg Laparosc Endosc 7: 263–265

    Google Scholar 

  23. John TG (1996) Anomalous biliary anatomy. Am J Surg 17: 543

    Google Scholar 

  24. Karanjia ND, Banerjee D, Dickson GH (1996) Angled metal cholangiography cannula for laparoscopic cholecystectomy. Br J Surg 83: 1441

    Google Scholar 

  25. Kwon AH, Uetsuji S, Ogura T, Kamiyama Y (1997) Spiral computed tomography scanning after intravenous infusion cholangiography for biliary duct anomalies. Am J Surg 174: 396–401

    Google Scholar 

  26. McWhorter GL (1923) A new method of gallbladder dissection with a consideration of the surgical anatomy. Surg Gynecol Obstet 36: 256–263

    Google Scholar 

  27. Moosman DA, Coller FA (1951) Prevention of traumatic injury to the bile ducts. Am J Surg 82: 132–143

    Google Scholar 

  28. Negri A (1950) Accidents opératoires au cours des interventions sur les voies biliaires. Rapport du 21ème Congres Argentin de Chirurgie, Buenos Aires.

  29. Ng JW, Yeung GH, Lee WM, Tse S (1996) Isolated duplications of the cystic duct: case report and implications in laparoscopic cholecystectomy. Surg Laparosc Endosc 6: 310–314

    Google Scholar 

  30. Perelman H (1961) Cystic duct duplication. J Am Med Ass 175: 710–711

    Google Scholar 

  31. Richardson MC, Bell G, Fullarton GM (1996) Incidence and nature of bile duct injuries following laparoscopic cholecystectomy: an audit of 5913 cases. West of Scotland Laparoscopic Cholecystectomy Audit Group. Br J Surg 83: 1356–1360

    Google Scholar 

  32. Sperling MJ (1965) Absence of cystic duct. Arch Surg 91: 1078

    Google Scholar 

  33. Williams C and Williams AM (1955) Abnormalities of the bile ducts. Ann Surg 141: 598–605

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. 10 Langley Road, SW19 3NZ, London, UK

    M. Lamah

  2. Worthing Hospital, Worthing, UK

    G. H. Dickson

Authors
  1. M. Lamah
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. H. Dickson
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lamah, M., Dickson, G.H. Congenital anatomical abnormalities of the extrahepatic biliary duct: a personal audit. Surg Radiol Anat 21, 325–327 (1999). https://doi.org/10.1007/BF01631333

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01631333

Key words

Search

Navigation