Risk of Gallstone Formation in Aberrant Extrahepatic Biliary Tract Anatomy: A Review of Literature

Ojo, A. O.; Pollard, Alicia

doi:10.7759/cureus.10009

Cited by 3 publications

(3 citation statements)

References 41 publications

(76 reference statements)

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“…Variations in the anatomy of the cystic duct are common findings in imaging studies and cholecystectomy reports, occurring in 18%-23% of individuals [2].…”

Section: Discussionmentioning

confidence: 99%

Untitled

2023

IJCMCR

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Anatomical variations of the cystic duct are common and frequently encountered. Different variations of the cystic duct are reported in the literature depending on its length, path and site of insertion. Failure to recognise some of these variations can lead to complications during surgery. All this requires anatomical knowledge and good intraoperative exploration to avoid traumatizing a noble organ. We report on a 48-year-old female patient who was admitted with clinical cholestasis syndrome. On general examination, the patient was conscious 15/15 and hemodynamically and respiratory stable. On abdominal examination, a slightly tender abdomen was found with an unremarkable rectal exam. The hepatic balance was disturbed. On radiological examination, the thoracic-abdominal-pelvic CT scan showed a locally advanced pancreatic head process, responsible for a bi-canal dilatation. The patient underwent retrograde cholecystectomy, latero-lateral choledochodenal diversion with segment III liver biopsy and subhepatic drainage with a delbet blade. On investigation, there was moderate ascites, a liver with metastases (segment III biopsy done and positive for invasive adenocarcinoma), a tumor mass opposite the head of the pancreas fixed to the deep plane and locally advanced measuring 5cm in length, the main bile duct dilated to about 2cm and an undistended gallbladder with an abnormal cystic duct outlet at the duodenum. We would like to share a very difficult clinical case and our experience with the support of the literature.

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“…Variations in the anatomy of the cystic duct are common findings in imaging studies and cholecystectomy reports, occurring in 18%-23% of individuals [2].…”

Section: Discussionmentioning

confidence: 99%

Untitled

2023

IJCMCR

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“…Gallstones in the bile duct are the major indication endoscopic retrograde cholangiopancreatography (ERCP) and have significant impact on quality of life and productivity of the patients. 14,15 There has been significant improvements in management strategies in recent decades with rapid advancement and evolution of research in biliary system. 14 Our study included 139 patients meeting inclusion criteria, of these 139 study cases, 49 (35.3%) were male and 90 (64.7%) were female patients with bile duct stone.…”

Section: Discussionmentioning

confidence: 99%

“…14,15 There has been significant improvements in management strategies in recent decades with rapid advancement and evolution of research in biliary system. 14 Our study included 139 patients meeting inclusion criteria, of these 139 study cases, 49 (35.3%) were male and 90 (64.7%) were female patients with bile duct stone. Odemis et al 16 has also reported 62% female patients with bile duct gall stones, similar to our results.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of bile duct stones extracted by ERCP (Endoscopic Retrograde Cholangio-Pancreatography).

Malghani

Nasir

2021

TPMJ

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Objective: To determine the frequency of different types of gallstones on ERCP stone extraction from bile duct. Study Design: Cross Sectional study. Setting: Department of Gastroenterology of the Nishtar Hospital Multan. Period: September 2019 to October 2020. Material & Methods: Patients with bile duct stones on imaging of either sex aged 18 – 70 years were included in our study while patients with IHD, malignancies, liver cirrhosis, asthma, TB, COPD, ILD and pregnant women were excluded from our study. During ERCP the gross appearance of extracted stones and related findings were noted. Results: Our study included 139 patients meeting inclusion criteria, of these 139 study cases, 49 (35.3%) were male and 90 (64.7%) were female patients with bile duct stone. Mean age was 45.78 ± 12.05 year (range; 27 – 68 years). Of these 139 study cases, 56 (40.3%) were from rural areas, 83 (59.7 %) were from urban areas, 52 (37.4%) had poor socioeconomic status and 87 (62.6%) were from middle income family background. Diabetes was noted in 35 (25.2%), hypertension in 53 (38.1%) and obesity in 32 (23 %) (Mean BMI was 26.53±214kg/m2). Mean stone size in our study was 15.82 ± 6.34 mm while 78 (56.12 %) had single stones. Pure cholesterol gallstones were noted in 47 (33.8%), mixed cholesterol stones in 71 (51.1%) and brown pigmented gall stones in 21 (15.1%). Conclusion: Mixed cholesterol stones were more frequent followed by pure cholesterol and brown pigmented stones in bile duct gallstones patients. Mixed cholesterol stones were significantly associated with rural residential status and hypertension while brown pigmented stones were residential status, hypertension and obesity.

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Si̇sti̇k Kanalin Ana Safra Kanalina Bi̇rleşme Yeri̇ni̇n Safra Taşi Ve/Veya Kolesi̇sti̇t Geli̇şi̇mi̇yle İli̇şki̇li̇ Olup Olmadiğinin MRKP İle Saptanmasi

KARAKAŞ,

ULUKENT,

KAYA

et al. 2023

SDÜ Tıp Fakültesi Dergisi

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Abstract Aim: The development of gallstones and stone-induced inflammatory processes depends on several biological factors. Knowledge of the predisposing factors for both the development of stones and their inflammation is important in predicting, monitoring, and treating the disease and subsequent complications. This study aimed to determine whether the length of the cystic duct (CD) and the level and direction of its junction with the common hepatic duct (CHD) are associated with cholecystitis and cholelithiasis. Material-Method : This retrospective study included 172 patients who underwent MRCP between January 2017 and December 2020. A 1.5 Tesla MR device (Signa HDI, General Electric, Milwaukee, WI, USA) was used with an HD 8-channel body array coil. The findings were analyzed using SPSS version 23 software. Results: The level at which the cystic duct (CD) joined the common hepatic duct (CHD) was not significantly correlated with the development of calculi or cholecystitis (p >0.05). The side of the CD joining the CHD was not significantly correlated with the development of calculi or cholecystitis (p>0.05). Of the 27(15.7%) patients with CD length less than 2 cm, 3(1.7%) had only stones, 8(4.7%) had cholecystitis, and 16(9.3%) were normal. Of the 88(51.2%) cases with a length between 2 and 4 cm, 43(25%) had only calculi, 19(11%) had cholecystitis with calculi, and 26(115.1%) were normal. Of the 57(33.1%) patients with cystic ducts longer than 4 cm, 31(18%) had only stones, 16(9.3%) had cholecystitis, and 10(5.8%) were normal, and the frequency of stones and cholestasis increased with increasing CD length (p

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Risk of Gallstone Formation in Aberrant Extrahepatic Biliary Tract Anatomy: A Review of Literature

Cited by 3 publications

References 41 publications

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Evaluation of bile duct stones extracted by ERCP (Endoscopic Retrograde Cholangio-Pancreatography).

Si̇sti̇k Kanalin Ana Safra Kanalina Bi̇rleşme Yeri̇ni̇n Safra Taşi Ve/Veya Kolesi̇sti̇t Geli̇şi̇mi̇yle İli̇şki̇li̇ Olup Olmadiğinin MRKP İle Saptanmasi

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