Anatomic Variations of the Right Hepatic Duct: Results and Surgical Implications from a Cadaveric Study

Abstract

Purpose. Thorough understanding of biliary anatomy is required when performing surgical interventions in the hepatobiliary system. This study describes the anatomical variations of right bile ducts in terms of branching and drainage patterns, and determines their frequency. Methods. We studied 73 samples of cadaveric material, focusing on the relationship of the right anterior and posterior segmental branches, the way they form the right hepatic duct, and the main variations of their drainage pattern. Results. The anatomy of the right hepatic duct was typical in 65.75% of samples. Ectopic drainage of the right anterior duct into the common hepatic duct was found in 15.07% and triple confluence in 9.59%. Ectopic drainage of the right posterior duct into the common hepatic duct was discovered in 2.74% and ectopic drainage of the right posterior duct into the left hepatic duct in 4.11%. Ectopic drainage of the right anterior duct into the left hepatic ductal system and ectopic drainage of the right posterior duct into the cystic duct was found in 1.37%. Conclusion. The branching pattern of the right hepatic duct was atypical in 34.25% of cases. Thus, knowledge of the anatomical variations of the extrahepatic bile ducts is important in many surgical cases.

Magnetic resonance cholangiopancreatography evaluation of intrahepatic bile duct variations with updated classification

“…The proper evaluation of the IHBD anatomy and its variations before liver transplantation and extensive liver resection is very important (17). LDLT using the right lobe has become a standard operation (18).…”

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

“…The presence of anomalies of the cystic duct and the hepatic bile ducts, for example with drainage of the cystic duct into the left side of the common hepatic duct, constitute one of the major causes of bile duct injuries after laparoscopic cholecystectomy [2,14]. Also, the knowledge of anatomical variations can help surgeons to plan potential living donor evaluation and liver resection surgery [3].…”

“…1and 3) was defined when the right posterior duct drained into the junction of the right anterior duct and the left main duct. Abnormal right configuration included an anomalous drainage of the right posterior duct, draining into the left main hep- [1][2][3][4][5]). Other rare variants at the level of bifurcation were quadrifurcation; filling defects evaluated as vascular compression on the common hepatic duct, aberrant right hepatic duct (insertion into the main hepatic duct proximally at the cystic duct, Fig.…”

“…The distribution of the intrahepatic biliary ducts is in harmony with the segmental anatomy of the liver. Intrahepatic biliary duct anatomy is coincident with liver segmental anatomy according to Couinaud classification [1,2]. The individual biliary drainage system is parallel to the portal system.…”

“…This typical biliary anatomy is reported to range between 58 and 68 % of cases ( Fig. 1; [1][2][3][4]). …”