Anatomical Variations of Extrahepatic Biliary Tract and Related Vessels during Laparoscopic Cholecystectomy
Keywords:
Laparoscopic Cholecystectomy, Anatomical Variations, Biliary Tract Anomalies, Surgical Outcomes, Gallstone DiseaseAbstract
OBJECTIVES
This study aims to add to the existing knowledge by evaluating the frequency of usual pathologies in the biliary system and blood vessels observed during Laparoscopic cholecystectomy.
METHODOLOGY
This cross-sectional study was conducted at the General Surgery Department of Hayatabad Medical Complex, Peshawar, from November 2022 to November 2023. The study comprised 65 patients aged 18-50 with known cases of cholelithiasis. Exclusion criteria included patients with empyema gallbladder, gallbladder carcinoma, and a history of diabetes mellitus or hypertension.
RESULTS
The mean age of patients was 40.1±3.95 years, with females comprising 64.6% and males comprising 35.4% of the sample. Overall, extrahepatic biliary tract anomalies were found in 24.6% of cases. The incidence of anatomic variations in the present study was as follows; a short cystic duct was the most frequent variation observed in the present study and was found in 9.2%, followed by a long cystic duct (7.7%), duct of Luschka, and Moynihan hump anomaly (3.1% each).
CONCLUSION
Out of all the parameters, short cystic duct predominated, emphasizing the significance of a perfect surgical approach. The fact that anomalies are distributed equally across the various demographics underlines their inherent attributes. These findings call for further research that will enhance the performance of surgeries and the benefits of laparoscopic cholecystectomy treatments.
Downloads
Metrics
References
Jarrar MS , Masmoudi M, Mraidha MH, Naouar N, Barka M, Youssef S, et al. Anatomic variations of the upper biliary confluence and intra-hepatic ducts in East-central Tunisian population. Ital J Anat Embryol. 2019;124(3): 487-98
Pinal-garcia DF, Nuno-guzman CM, Gonzalez-gon-zalez ME. The Celiac Trunk and Its Anatomical Variations : A Cadaveric Study. 2018;10(4):321–9
Ogut E, Yildirim FB, Memis O: Duplicated gallbladder with acute cholecystitis: a case of unusual presentation and diagnostic challenges. World J Emerg Med. 2024, 15:156-8. doi:10.5847/wjem.j.1920-8642.2024.021
Zhu AY, Seyfi D, Sandroussi C, Abeysinghe JD: Aberrant vascular anatomy during laparoscopic cholecystectomy: a case report of double cystic artery. CRSLS. 2023, 10:e2023.00038. doi:10.4293/CRSLS.2023.00038
Jarrar MS, Fourati A, Fadhl H, Youssef S, Mahjoub M, Khouadja H, et al. Risk factors of conversion in laparoscopic cholecystectomies for lithiasic acute cholecystitis. Results of a monocentric study and review of the literature. Tunis Med. 2019;97(2): 344-51
Abdulrasool H, Briggs C: Anatomical variation of arterial blood supply of liver segment IV. Eur J Anat. 2018, 22:375-7
Gupta R, Kumar A, Hariprasad CP, Kumar M. Anatomical variations of cystic artery, cystic duct, and gall bladder and their associated intraoperative and postoperative complications: an observational study. Ann Med Surg (Lond). 2023 Jul 10;85(8):3880-3886.doi:10.1097/MS9.0000000000001079. PMID: 37554913; PMCID: PMC10406088
Grifson JJ, Perungo T, Sengamalai D, Duraisamy B, Anbalagan A, Raju P, Kannan DG: Anomalous middle hepatic artery in laparoscopic cholecystectomy: wolf in sheep’s clothing. J Minim Access Surg. 2017, 13:76-7.doi:10.4103/0972-9941.181383
Kim SH, Park S, Choi J: A cystic artery arising from the middle hepatic artery detected during laparoscopic cholecystectomy: a case report. J Surg Case Rep. 2022, 2022:rjab088.doi:10.1093/jscr/rjab088
Gupta V: How to achieve the critical view of safety for safe laparoscopic cholecystectomy: technical aspects. Ann Hepatobiliary Pancreat Surg. 2023, 27:201-10.doi:10.14701/ahbps.22-064
Boghdady ME, Arang H, Ewalds-Kvist BM: Fundus-first laparoscopic cholecystectomy for complex gallbladders: a systematic review. Health Sci Rev. 2022, 2:581-4.doi:10.1016/j.hsr.2022.100014
Mlakar B, Gadzijev EM, Ravnik D, et al. . Anatomical variations of the cystic artery. Eur J Morphol 2003;41:31–34
Fernandez Trokhimtchouk T, Flores LF, Morillo Cox Á, Otanez ES, Negrete JR, Ayala AV. Unusual Anatomic Variant of the Biliary Tree. Cureus. 2023 Oct 17;15(10):e47206. doi:10.7759/cureus.47206. PMID: 38021781; PMCID: PMC10653010
Halpern SA, Patrizio HA, Brace EJ, Wang S, Yuh JY, Patel DV, Morrison RG, Hall AJ, Falciani A, Deiling KA, Brolis NV. Anatomical Considerations for Gallbladder Sonography: A Cross-Sectional Study of CT Imaging by BMI Group. Cureus. 2023 Jun 17;15(6):e40557.doi:10.7759/cureus.40557. PMID: 37465802; PMCID: PMC10351329
Andall RG, Matusz P, du Plessis M, Ward R, Tubbs RS, Loukas M. The clinical anatomy of cystic artery variations: a review of over 9800 cases. Surg Radiol Anat. 2016 Jul;38(5):529-39.doi: 10.1007/s00276-015-1600-y. Epub 2015 Dec 23. PMID: 26698600
Asghar A, Priya A, Patra A, Gupta P, Kumar A. Moynihan’s hump of the right hepatic artery in Calot's triangle: a systematic review and meta-analysis of its incidence and surgical importance. Surg Radiol Anat. 2023 May;45(5):643-651.doi: 10.1007/s00276-023-03125-8. Epub 2023 Mar 17. PMID: 36932210
Porzionato A, Macchi V, Stecco C, Boscolo-Berto R, Loukas M, Tubbs RS, De Caro R. Clinical Anatomy and Medical Malpractice-A Narrative Review with Methodological Implications. Healthcare (Basel). 2022 Sep 30;10(10):1915.doi: 10.3390/healthcare10101915. PMID: 36292362; PMCID: PMC9601975
Narlapati HM, Telian SH, Peirce GS, Kaplan AJ. A Type V Aberrant Right Hepatic Duct Branching from the Cystic Duct: The Paramount Importance of Intraoperative Cholangiography in Supplementing the Critical View of Safety Technique in Laparoscopic Cholecystectomy. CRSLS. 2022 Mar 28;9(2):e2022.00005.doi:10.4293/CRSLS.2022.00005. PMID: 36017506; PMCID: PMC9387367
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Muhammad Bilawal Khan, Muhammad Iftikhar, Siddique Ahmad
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
