Cystic Duct Opening into Right Hepatic Duct; a Disaster Waiting to Happen During Cholecystectomy: A Case Report

Chaudhary, Rajesh; Sharma, K Aparna

doi:10.21767/2172-0479.100059

Cited by 3 publications

(4 citation statements)

References 5 publications

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“…A single (2%) study participant had the cystic duct drained through the right hepatic duct. This corresponds to the findings of previous studies who found that cystic duct may join the right hepatic duct in 0.6%-2.3% cases (17,18).…”

Section: Cystic Ductssupporting

confidence: 92%

“…These findings compare to an American study which found that the cystic duct enters the extrahepatic bile duct from the right lateral aspect in 49.9% of cases, from the medial aspect (left) in 18.4%, and from an anterior or posterior position in 31.7% (16). An Indian study found a medial (left) insertion in 10%-17% (17). A single (2%) study participant had the cystic duct drained through the right hepatic duct.…”

Section: Discussionmentioning

confidence: 99%

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Surgically Important Anatomic Variations of Extrahepatic Biliary System Among Black Kenyan Cadavers at Moi University Human Anatomy Laboratory

Ndiwa

Wandera

Njoroge

et al. 2023

Preprint

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Background: Anatomical variations of the human body including the extra hepatic biliary system exist across various individuals. Understanding the variant anatomy of the extrahepatic biliary system aids surgeons in avoiding iatrogenic injuries. This is important in resource limited settings where it is not possible to perform adequate radiological investigations of the hepatobiliary system prior to surgery. This study described the anatomic variation of the extrahepatic biliary system among Kenyans. Methods: This was a cross-sectional study conducted at Moi University Anatomy Laboratories among 42 adult cadaveric specimens. Specimen dissections were conducted as per the fifteenth edition of Cunningham manual of Practical Anatomy. The variant anatomy data collected were filled in a structured data collection form, analyzed and presented using descriptive statistics. Study Findings: Of the 42 cadavers sampled, 62% (n=26) were male while 38% (n=16) were female. All had a gall bladder being drained by the cystic duct. The length of the cystic duct ranged between 7-35 mm joining the common hepatic duct to form the common bile duct in 98% (n=41) of all the cadavers sampled. This confluence was to the left in 7.1% (n=3), right 42.9% (n=18), anteriorly in 14.3% (n=6) and posteriorly 35.7% (n=14). A single cadaver (2%) had the cystic duct drain into the right hepatic duct. Two thirds (66.7%; n=28) of the cadavers sampled had the confluence of the right and the left hepatic duct outside the liver. There were no cholecystohepatic ducts in this study. Conclusion: The study determined the existence of surgically important variant anatomy of the extrahepatic biliary system. There is need for greater appreciation of the extrahepatic biliary system variant anatomy by both surgeons and radiologists so as to decrease morbidity and improve on surgical outcomes.

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Section: Cystic Ductssupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Surgically Important Anatomic Variations of Extrahepatic Biliary System Among Black Kenyan Cadavers at Moi University Human Anatomy Laboratory

Ndiwa

Wandera

Njoroge

et al. 2023

Preprint

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“…This fi nding is compatable with a case study done in Brazil. The right hepatic duct may be mistakenly ligated and severed being considered as a cystic duct and may lead to severe complications in patient 18 . Another variation called apparent common bile duct was observed in 6 (1.36%) patients.…”

Section: Discussionmentioning

confidence: 99%

Anatomical Variations in Cystic Duct Observed in Patients During Open Cholecystectomy at Hayatabad Medical Complex, Peshawar.

Iftikhar,

Naz,

Rehman

et al. 2024

J Khyber Coll Dent

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Objectives: To dermine the type of morphology of the cystic duct and to file the occurrence of anatomical variations in the people of Khyber Pakhtunkhwa.Materials and Methods: This was a descriptive study having a total number of 220 patients were selected for the study undergoing open cholecystectomy. This includ- ed both female and male cases. All patients were operated by open cholecystectomy procedure. During the surgicalprocedure Calot’s triangle was identifi ed and the junction of cystic duct with the common hepatic duct was carefully observed and any variation in the morphology of cystic duct was observed and were noted on a proforma.Results: Out of 220 patients, Normal anatomy was observed in 164 patients (74.54%). Anomalies were observed in 56 patients(25.45%) . Small cystic duct was the most common anomaly observed in 21 (9.54%) patients. 19 (8.63%) cases were observed to have long cystic ducts. The cystic duct entering the right hepatic duct was observed in 10 (4.54%) cases. Apparent common bile ducts(ACBD) were found in 6 (1.36%) patients.Conclusion: The extrahepatic biliary tree is the region mostly prone to anatomical variations. Cystic duct has been observed to be having a diversity of anatomical variations affecting the biliary tree. Hence it is mandatory for the surgeons to have an accurate acquaintance to standardanatomy and anatomical variations of the cystic duct to avoid any complications during and after cholecystectomy.

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“…(7) The double cystic duct opening into the right hepatic duct has been observed in 1 dissection, that of a female cadaveric specimen(Fig- 9) .This condition is very rare with very few cases reported in world literature. (18,19,20) Double cystic duct i.e. one draining into the RHD and one to the CHD has been observed in 1 dissection (1%) in a specimen belonging to a male cadaver.…”

Section: Discussionmentioning

confidence: 99%

Variations in the Termination of Cystic Duct by gross Dissection Method: A Report of 100 Cases of Odishan Population

Ray¹

2018

jmscr

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Introduction:The Cystic duct is about 3 cm in length but variable. It terminates usually in the supraduodenal region into the R.H.D .But on many occasions it displays aberrations from the normal. The study is an attempt to find out the incidence of cystic duct termination by gross anatomic dissection. Methods: The study was carried out in 100 Cadaveric liver specimen with attached extrabiliary apparatus. The sexual frequency of 45 male cadaveric and 55 female cadaveric specimens. The termination of cystic duct was studied and photographed. Results: 90% of cystic duct terminated in the RHD. But a few opened into the LHD i.e 3% opened into the LHD.A case of double cystic duct into the RHD and a case of absent cystic duct were observed. One case of double cystic duct opening into the RHD and CHD was noted, 2 % cases of segmental ducts opening into the gall bladder was observed. Discussion: The study was conducted to observe the percentages of different termination of cystic duct, which is quite important for G.I. surgeons operating in this area. The study has been compared with similar studies on different ethnic groups in the world.

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Cystic Duct Opening into Right Hepatic Duct; a Disaster Waiting to Happen During Cholecystectomy: A Case Report

Cited by 3 publications

References 5 publications

Surgically Important Anatomic Variations of Extrahepatic Biliary System Among Black Kenyan Cadavers at Moi University Human Anatomy Laboratory

Surgically Important Anatomic Variations of Extrahepatic Biliary System Among Black Kenyan Cadavers at Moi University Human Anatomy Laboratory

Anatomical Variations in Cystic Duct Observed in Patients During Open Cholecystectomy at Hayatabad Medical Complex, Peshawar.

Variations in the Termination of Cystic Duct by gross Dissection Method: A Report of 100 Cases of Odishan Population

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