Comparative Analysis of Anatomy Following Intraoperative Cholangiograms in Elective Laparoscopic Cholecystectomies

Hosam Elghannam, Vikram Malik, Hasib Bhojwani

Abstract


Background: Laparoscopic cholecystectomies are performed more than 650,000 times per year in the United States. The importance of understanding the anatomy of the biliary system variants is essential to all surgical procedures, which can minimize surgical errors and common bile duct (CBD) injuries. Anatomic variants are seen in 18-39% of cholecystectomies, wherein 3-6% lead to increased risk of biliary tract injuries. We aim to show that anatomic variants do exist at a substantial rate and that performing intraoperative cholangiograms can prevent associated complications.

Methods: Data on 22 elective laparoscopic cholecystectomies due to acute cholecystitis were collected. All received intraoperative cholangiograms utilizing standard angiographic catheterization. Intraoperative cholangiograms were evaluated for anatomic variants. Complications were noted to compare and document relative risk of each anatomic variant.

Results: Thirty-six percent of patients presented with anatomic variations in their biliary system, right posterior segmental duct (RPSD) draining into the CBD, trifurcation of right anterior segmental duct (RASD), RPSD, and left hepatic duct (LHD) draining into the CBD, and accessory hepatic duct draining into common hepatic duct; all occurred at the same frequency of 10.5% each respectively, with the remaining 5.26% coming from patients with the RPSD draining into the LHD. Patients with anatomic variations had zero intraoperative complication.

Conclusion: This study highlights the importance of intraoperative cholangiograms in understanding the anatomy of the biliary system, and minimizing bile duct injuries to prevent the morbid risk associated with the procedure for those patients with variations in ductal anatomy.




J Curr Surg. 2015;5(4):183-187
doi: http://dx.doi.org/10.14740/jcs280w

 


Keywords


Intraoperative cholangiogram; Gallbladder; Cholecystectomy; Anatomy; Biliary system

Full Text: HTML PDF
 

Browse  Journals  

     

Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics

World Journal of Oncology

Gastroenterology Research

Journal of Hematology

Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity

Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research

Journal of Neurology Research

International Journal of Clinical Pediatrics

 

 

 

 

 

Journal of Current Surgery, quarterly, ISSN 1927-1298 (print), 1927-1301 (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)


This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.currentsurgery.org   editorial contact: editor@currentsurgery.org
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.