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Year : 2015  |  Volume : 4  |  Issue : 3  |  Page : 147-150

Anatomic variations of intra- and extra-hepatic biliary system in the Kingdom of Saudi Arabia

Department of Surgery, College of Medicine, Taif University, Taif, Saudi Arabia

Correspondence Address:
Bilal Omar Al-Jiffry
Department of Surgery, College of Medicine, Taif University, PO Box 888, Taif 21947
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2278-0521.165492

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Background: Data of the pattern of the anatomical variations from the Middle East are lacking as compared with the literature available elsewhere. The aim of this study was to evaluate the value of routine intraoperative cholangiogram (IOC) to find the pattern of anatomical variations of the biliary tree in patients performing laparoscopic cholecystectomy at Al Hada Military Hospital, Taif, Saudi Arabia. Materials and Methods: Performing routine IOC to all patients undergoing laparoscopic cholecystectomy from May 2010 to December 2011 and examining the cholangiograms by a single hepatobiliary surgeon to record the anatomical patterns. Results: The total number of patients was 177. Normal anatomy was found in 59% of patients. The anatomical variations included; type B (10.7%), type C1 (11.3%), type C2 (6.7), type D1 (4), type D2 (2.2), type E1 (2.8%), type E2 (1.1%), and type F (1.1%). In addition of 1.2% with complex nonrecorded variations. With regards to the cystic duct variations, we found the normal direct cystic duct in 74.6%, type B 14.1, and type C in 11.3. Conclusion: Anatomical variations observed in the present study is nearly similar to that reported in the literature, with two cases of complex biliary anatomy and not described before and further reappearance in other cholangiograms must be kept in mind. However, a higher number of type C cystic duct variations were observed in our study that could cause a higher number of bile duct injuries in laparoscopic cholecystectomy if not recognized.

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