%0 Journal Article
%T Anatomic Variations of the Right Hepatic Duct: Results and Surgical Implications from a Cadaveric Study
%A Theodoros Mariolis-Sapsakos
%A Vasileios Kalles
%A Konstantinos Papatheodorou
%A Nikolaos Goutas
%A Ioannis Papapanagiotou
%A Ioannis Flessas
%A Ioannis Kaklamanos
%A Demetrios L. Arvanitis
%A Evangelos Konstantinou
%A Markos N. Sgantzos
%J Anatomy Research International
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/838179
%X 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. 1. Purpose Anatomic variations of the extrahepatic bile ducts are important during surgical procedures such as laparoscopic cholecystectomy, liver resection (hepatectomy, segmentectomy), and living donor transplantation [1, 2]. It has been shown that the frequency of bile duct injuries occurring during laparoscopic cholecystectomies is twice as high as those occurring during open cholecystectomies [3]. Furthermore, evaluation of the biliary anatomy is essential before hepatic lobectomy or segmentectomy, as inaccurate determination of existing biliary anatomic variations may potentiate ligature or section of aberrant ducts, leading to major complications such as leakage or atrophy of the residual liver [2]. Therefore, it is apparent that thorough knowledge and successful detection and recognition of such anatomic variations can lead to decreased morbidity and mortality rates during hepatobiliary surgery. Although several methods, like CT or MR cholangiograms, have become the modality of choice for noninvasive evaluation of abnormalities of the biliary tract, they are not routinely used in preoperative imaging evaluation of patients undergoing common procedures such as laparoscopic cholecystectomy. Also, several uncommon¡ªand usually more complicated¡ªanatomic variations of the bile duct have been described.
%U http://www.hindawi.com/journals/ari/2012/838179/