ANATOMICAL VARIATIONS IN CYSTIC DUCT OBSERVED IN PATIENTS DURING OPEN CHOLECYSTECTOMY AT HAYATABAD MEDICAL COMPLEX, PESHAWAR.

Authors

  • Shazia Iftikhar Department of Anatomy, Khyber Medical College, KhyberPakhtunkhwa, Peshawar, Pakistan.
  • Falak Naz Department of Anatomy, Khyber Medical College, KhyberPakhtunkhwa, Peshawar, Pakistan.
  • Zainab Rehman Department of Anatomy, Khyber Medical College, KhyberPakhtunkhwa, Peshawar, Pakistan.
  • Nazish Waheed Department of Anatomy,Northwest Medical College, Khyber Pakhtunkhwa, Peshawar, Pakistan.
  • Maryam Ijaz 4th Year BDS Student, Rehman College of Dentistry, Peshawar, Pakistan.
  • Sarah Rehman Fauji Foundation Hospital, Pakistan.

DOI:

https://doi.org/10.33279/jkcd.v14i2.677

Keywords:

Cholecystectomy, Extrahepatic biliary tree, CHD, CD, CBD

Abstract

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 surgical
procedure 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 standard
anatomy and anatomical variations of the cystic duct to avoid any complications during and after cholecystectomy.

References

Dawani S, Sandhya A, Rasul S, Ali M. Frequency of common anatomical variations in the extrahepatic biliary tract in patients undergoing elective cholecystectomy. Pak J Surg. 2013;29(1):61-5.

Cachoeira E, Rivas A, Gabrielli C. Anatomic variations of extrahepatic bile ducts and evaluation of the length of ducts composing the cystohepatic triangle. Int J Morphol. 2012;30(1):279-83. DOI: https://doi.org/10.4067/S0717-95022012000100050

Toouli J, Bhandari M. Anatomy and physiology of the biliary tree and gallbladder. Diseases of the Gallbladder and Bile Ducts Diagnosis and Treatment, Second Edition Massachusetts: Blackwell Publishing. 2006:3-21. DOI: https://doi.org/10.1002/9780470986981.ch1

RAJguRu J, Mistry P. A Study of Confluence Pattern of Hepatic Ducts at Porta Hepatis and its Clinical Significance. International Journal of Anatomy, Radiology and Surgery. 2016;5(4):12-7.

CONTENT S. Evaluative Report of the Departments Sri Siddhartha Medical College: Sri Siddhartha Academy of Higher Education; 2008.

Ressurreição J, Batista L, Soares J, Marques I, Matos E, Andrade L, et al., editors. Normal anatomy and anatomic variants of the biliary tree and pancreatic ductal system at MRCP-what the clinicians want to know. European Society of Radiology, Congress ECR; 2014.

Ellis H. Anatomy of the gallbladder and bile ducts. Surgery (Oxford). 2011;29(12):593-6. DOI: https://doi.org/10.1016/j.mpsur.2011.09.011

Turner MA, Fulcher AS. The cystic duct: normal anato- my and disease processes. Radiographics. 2001;21(1):3- 22.

Chamberlain RS. Essential functional hepatic and biliary anatomy for the surgeon. Hepatic Surgery: IntechOpen; 2013.

Blidaru D, Blidaru M, Pop C, Crivii C, Seceleanu A. The common bile duct: size, course, relations. Romanian Journal of Morphology and Embryology. 2010;51(1):141-4.

Keplinger KM, Bloomston M. Anatomy and embryology of the biliary tract. Surgical Clinics. 2014;94(2):203-17. DOI: https://doi.org/10.1016/j.suc.2014.01.001

Talpur K, Hussain A, Syed BM, Sangrasi AK, Laghari AA, Malik AM, et al. Cystic Duct Anomalies and their Surgical Implications in Patients Undergoing Lapa- roscopic Cholecystectomy. JOURNAL OF THE LI- AQUAT UNIVERSITY OF MEDICAL AND HEALTH SCIENCES. 2016;15(2):63-6. DOI: https://doi.org/10.22442/jlumhs.161520466

Sarawagi R, Sundar S, Gupta SK, Raghuwanshi S. Ana- tomical variations of cystic ducts in magnetic resonance cholangiopancreatography and clinical implications. Radiology research and practice. 2016;2016. DOI: https://doi.org/10.1155/2016/3021484

Shaikh B, Baloach IB, Shaikh SA. Anatomical vari- ations: Dangerous culprits behind difficult cholecys- tectomies. Rawal Medical Journal. 2016;41(3):316-9.

Talpur KAH, Laghari AA, Yousfani SA, Malik AM, Memon AI, Khan SA. Anatomical variations and congenital anomalies of extra hepatic biliary system encountered during laparoscopic cholecystectomy. JPMA The Journal of the Pakistan Medical Association. 2010;60(2):89.

Khayat MF, Al-Amoodi MS, Aldaqal SM, Sibiany A. Abnormal anatomical variations of extra-hepatic biliary tract, and their relation to biliary tract injuries and stones formation. Gastroenterology research. 2014;7(1):12. DOI: https://doi.org/10.14740/gr596e

Karimian F, Aminian A, Mirsharifi R, Mehrkhani F. Sur- gical options in the management of cystic duct avulsion during laparoscopic cholecystectomy. Patient safety in surgery. 2008;2(1):17. DOI: https://doi.org/10.1186/1754-9493-2-17

Chaudhary R, Sharma K, Shukla A. Cystic Duct Opening into Right Hepatic Duct; a Disaster Waiting to Happen During Cholecystectomy: A Case Report. Transl Biomed. 2016;7:2. DOI: https://doi.org/10.21767/2172-0479.100059

Turner MA, Fulcher AS. The cystic duct: normal anatomy and disease processes. Radiographics. 2001 Jan;21(1):3-22. DOI: https://doi.org/10.1148/radiographics.21.1.g01ja093

Downloads

Published

2024-06-20

How to Cite

Iftikhar, S., Naz, F., Rehman, Z. ., Waheed, N. ., Ijaz, M. ., & Rehman, . S. . (2024). ANATOMICAL VARIATIONS IN CYSTIC DUCT OBSERVED IN PATIENTS DURING OPEN CHOLECYSTECTOMY AT HAYATABAD MEDICAL COMPLEX, PESHAWAR. JOURNAL OF KHYBER COLLEGE OF DENTISTRY, 14(02), 25–28. https://doi.org/10.33279/jkcd.v14i2.677

Issue

Vol. 14 No. 02 (2024): Journal of Khyber College of Dentistry

Section

Original Article

License

Copyright (c) 2024 shazia ijaz, Zainab Rehman, falak Naz

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

You are free to:

  1. Share — copy and redistribute the material in any medium or format
  2. Adapt — remix, transform, and build upon the material
  3. The licensor cannot revoke these freedoms as long as you follow the license terms.

Under the following terms:

  1. Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
  2. NonCommercial — You may not use the material for commercial purposes .
  3. No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.