International Journal of Research in Medical Sciences | July 2017 | Vol 5 | Issue 7 Page 3071
International Journal of Research in Medical Sciences
Parmar P et al. Int J Res Med Sci. 2017 Jul;5(7):3071-3075
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
Original Research Article
Biliary ductal variations and its clinical implications: a cadaveric study
Priyanka Parmar
1
*, Suresh Kanta Rathee
1
, SK Dhattarwal
2
, Sanjay Marwah
3
INTRODUCTION
Extrahepatic biliary tract is comprised of cystic duct,
right and left hepatic duct, common hepatic duct and
common bile duct. It is known for the transportation of
bile from liver to 2
nd
part of duodenum. Accessory bile
ducts are among the well-known variations of this region.
These are narrow channels running from the right lobe of
the liver in to the anterior surface of the body of the gall
bladder usually. In cases, the cystic duct opens into an
accessory hepatic duct rather than in to the common
hepatic duct.
1
Persistence of fetal connection between liver and gall
bladder or delayed division of hepatic antrum into hepatic
and cystic diverticula may lead to accessory ducts.
2
Knowledge of the embryonic development is helpful in
understanding the location and pattern of anomalies of
the biliary duct system.
3
These anomalies may add to operative difficulties during
cholecystectomy and due to the scarcity of studies of this
regional anatomy, the exact incidence of such variations
is not known. The present study is a humble attempt to
reinforce awareness among clinicians and anatomists
regarding ductal variations in order to reduce
postoperative morbidity and mortality.
4
METHODS
The present study was conducted on 50 adult Human
cadavers in the department of Anatomy in collaboration
with the department of Forensic Medicine and
department of Surgery, BD Sharma PGIMS, Rohtak,
India during medico-legal autopsies done in the
1
Department of Anatomy, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak,
Haryana, India
2
Department of Forensic Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences,
Rohtak, Haryana, India
3
Department of Surgery, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana,
India
Received: 22 April 2017
Accepted: 18 May 2017
*Correspondence:
Dr. Priyanka Parmar,
E-mail: drpriyamlbmc@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20172989
ABSTRACT
Background: Biliary ductal region being frequently abnormal has been the subject of research since long time for
anatomists, surgeons and radiologists as well.
Methods: The present study was carried out in the department of Anatomy at PGIMS, Rohtak on 50 specimens of
liver taken unblock with associated structures.
Results: Accessory hepatic and accessory cystic ducts were observed in 4% cases each. 2% cases exhibited abnormal
low fusion of cystic duct with common hepatic duct.
Conclusions: These anomalies may add to postoperative complications if ignored. Present study is a step in the
direction of creating awareness about these variations among the clinicians.
Keywords: Accessory, Biliary, Hepatic