Evaluation of Aberrant Bile Ducts Before Laparoscopic Cholecystectomy

Hirao, Koichi; Miyazaki, Atsushi; Fujimoto, Toshifumi; Isomoto, Ichiro; Hayashi, Kuniaki

doi:10.2214/ajr.175.3.1750713

Cited by 86 publications

(62 citation statements)

References 32 publications

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“…Familiarity with these two different entities is important clinically because an aberrant bile duct is the only bile duct draining a particular hepatic segment, whereas an accessory one is an additional bile duct draining the same area of the liver. 29 Therefore, inadvertent ligation of aberrant branches draining the remnant liver would lead to atrophy of the involved portions. The direct drainage of the right posterior duct into the common hepatic duct, right-or left-sided, is a variant also known as the aberrant hepatic duct and is present in approximately 5% and less than 1% of the population, respectively.…”

Section: Biliary Tract Anatomymentioning

confidence: 99%

Preoperative liver donor evaluation: Imaging and pitfalls

Mortelé

Cantisani

Troisi

et al. 2003

Liver Transplantation

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This article discusses the rationale behind living (related) donor liver transplantation, the role of imaging in the preoperative evaluation of the potential donor, and the currently available imaging modalities for fulfilling this task. Furthermore, the normal hepatic vascular and biliary anatomy, as seen on imaging, is reviewed and the most common anomalies are highlighted. Finally, critical concepts in the diagnostic evaluation of a donor are discussed with special emphasis on how to accurately measure liver volumes. (Liver Transpl 2003;9:S6-S14.)

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Section: Biliary Tract Anatomymentioning

confidence: 99%

Preoperative liver donor evaluation: Imaging and pitfalls

Mortelé

Cantisani

Troisi

et al. 2003

Liver Transplantation

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“…1) and biliary branching patterns ( Fig. 2) while referring to previously published classifications (1)(2)(3)(4)(5)15). For each image set the two readers independently recorded their interpretation of cystic duct variation and biliary branching patterns.…”

Section: Image Analysismentioning

confidence: 99%

“…MANY ANATOMICAL VARIATIONS of the biliary tracts are known (1)(2)(3)(4)(5). Variations of the cystic ducts and biliary branches may cause difficulty during laparoscopic cholecystectomy (1,2).…”

mentioning

confidence: 99%

“…Two noninvasive imaging techniques to evaluate biliary anatomies are currently in widespread use: magnetic resonance cholangiopancreatography (MRCP) and computed tomographic (CT) cholangiography (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). With regard to CT cholangiography, high spatial resolution 3D biliary images have recently been obtained using intravenous or oral cholangiographic contrast material thanks to the development of multidetector CT (4 -9).…”

mentioning

confidence: 99%

“…With regard to CT cholangiography, high spatial resolution 3D biliary images have recently been obtained using intravenous or oral cholangiographic contrast material thanks to the development of multidetector CT (4 -9). Volume-rendering (VR) reformation has been successfully applied to evaluate 3D biliary anatomies (4,5,7,9). However, CT cholangiography has some possible disadvantages: the necessity for radiation exposure, possibility of adverse reaction caused by ionic iodine contrast medium, and a lack of suitability for patients with hyperbilirubinemia (6).…”

mentioning

confidence: 99%

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Biliary anatomy on 3D MRCP: Comparison of volume‐rendering and maximum‐intensity‐projection algorithms

Morita

Saito

Suzuki

et al. 2009

Magnetic Resonance Imaging

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Purpose: To compare volume-rendering (VR) and maximum-intensity-projection (MIP) of three-dimensional T2-weighted turbo spin-echo magnetic resonance cholangiopancreatography using a free-breathing navigatortriggered prospective acquisition correction (3D-TSE-PACE-MRCP) to define biliary anatomies. Materials and Methods:VR and MIP images of 3D-TSE-PACE-MRCP for 102 patients were retrospectively evaluated. Interpretation of cystic duct variation and biliary branching patterns of each image were recorded independently by two radiologists in a blinded fashion. Interpretation confidence on a five-point scale was compared using the Wilcoxon signed-rank test. The McNemar test was used to compare the accuracies of each reformation with the reference standard obtained by consensus interpretation of both the images and source images. Results:The reference standard identified all biliary bifurcations and 95 of 102 cystic duct confluences (93.1%). VR findings agreed with the reference standard findings more often than MIP with regard to cystic duct variation (94 [92.2%] vs. 76 [74.5%], P Ͻ 0.01) while there was no significant difference for biliary branching patterns (99 [97.1%] vs. 92 [90.2%], P ϭ 0.092). The mean confidence score was significantly higher with VR than MIP with regard to both cystic duct variation and biliary branching patterns (3.7 vs. 2.4; P Ͻ 0.01; 4.1 vs. 3.3; P Ͻ 0.01).Conclusion: VR reformation of 3D-TSE-PACE-MRCP defines biliary anatomies more accurately than MIP.

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