Anatomic Variations of Extrahepatic Bile Ducts and Evaluation of the Length of Ducts Composing the Cystohepatic Triangle

DOI : http://dx.doi.org/10.4067/S0717-95022012000100050
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Eduardo Cachoeira; Antonio Rivas & Carla Gabrielli

Summary

It is of paramount importance for surgeons to have a thorough knowledge of the normal anatomy of the extrahepatic bile ducts and its variations due to the high frequency with which they perform in this anatomic site. The cystohepatic triangle, or Calot's Triangle, is bound by the cystic duct, common hepatic duct, and the hepatic border; therefore, its surface area depends on the conformation of these ducts and is closely linked to surgical procedures performed in this region. It has been reported that the length and the position of these ducts may be related to the formation of bile duct stones, Mirizzi's syndrome, and bile duct cancer. Thus, the present work aims to analyze the configuration of the extrahepatic biliary tree and its possible variations, as well as measure the components that make up the cystohepatic triangle. For this task 41 samples from fixated human cadavers were analyzed, with 25 consisting of anatomic parts (liver and biliary tree) and 16 in situ samples. The extrahepatic biliary trees were dissected in order to measure the length of the common hepatic and cystic ducts with a digital caliper, and all anatomic variations were registered. The length of the common hepatic duct varied between 4.18 mm and 50.64 mm, with an average of 21.76 ± 9.51 mm. The length of the cystic duct varied between 7.28 and 38.88 mm, with an average of 19.11 ± 6.77 mm. Anatomic variations were found in 3 samples (7.3%): in one of them the cystic duct connected to the left hepatic duct; in another, the cystic duct connected to the right hepatic duct; in the third, there was a triple confluence of hepatic ducts (two right ducts and one left duct). The results are a contribution to the clinical and surgical anatomy of this region.

KEY WORDS: Anatomy; Cystohepatic triangle, Common hepatic duct; Cystic duct; Cholecystectomy.

How to cite this article

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., 30(1):279-283, 2012.