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Surgical and Radiologic Anatomy

, Volume 41, Issue 9, pp 1087–1092 | Cite as

Rare anatomic variations of the right hepatic biliary system

  • Shallu Garg
  • Hemanth Kumar
  • Daisy SahniEmail author
  • T. D. Yadav
  • Anjali Aggarwal
  • Tulika Gupta
Anatomic Variations
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Abstract

Purpose

To report rare and clinically significant anatomic variations in the biliary drainage of right hepatic lobe.

Methods

Unique variations in the extra- and intrahepatic biliary drainage of right hepatic lobe were observed in 6 cadaveric livers during dissection on 100 formalin-fixed en bloc cadaveric livers.

Results

There was presence of aberrant drainage of right segmental and sectorial ducts in four cases and of accessory right posterior sectorial duct in two cases.

Conclusions

We encountered some extensively complicated biliary drainage of right hepatic lobe, unsuccessful recognition of which can lead to serious biliary complications during hepatobiliary surgeries and biliary interventions.

Keywords

Hepatic ducts Biliary anatomy Liver anatomy Hepatobiliary surgery 

Notes

Acknowledgements

This research was funded by the Indian Council of Medical Research (Grant No. 51/2/2010-Ana/BMS), New Delhi, India. The authors thank Mr. Dharamjit Singh, Senior Artist, for the artwork. We also wish to thank all the donors of the cadavers used for the present study.

Author’s contribution

SG: Data collection, data analysis, manuscript writing; KHK: data collection, data analysis, manuscript editing; DS: project development, manuscript editing; TDY: project development, manuscript editing; AA: data analysis, manuscript writing; TG: manuscript editing.

Funding

Indian Council of Medical Research (ICMR), New Delhi, India.

Compliance with ethical standards

Conflict of interest

None.

References

  1. 1.
    Catalano OA, Singh AH, Uppot RN, Hahn PF, Ferrone CR, Sahani DV (2008) Vascular and biliary variants in the liver: implications for liver surgery. Radiographics 28:359–378CrossRefGoogle Scholar
  2. 2.
    Cho A, Asano T, Yamamoto H, Nagata M, Takiguchi N, Kainuma O, Soda H, Mori M, Narumoto S, Okazumi S, Makino H, Ochiai T, Ryu M (2007) Relationship between right portal and biliary systems based on reclassification of the liver. Am J Surg 193:1–4CrossRefGoogle Scholar
  3. 3.
    Choi JW, Kim TK, Kim KW, Kim AY, Kim PN, Ha HK, Lee MG (2003) Anatomic variation in intrahepatic bile ducts: an analysis of intraoperative cholangiograms in 300 consecutive donors for living donor liver transplantation. Korean J Radiol 4:85–90CrossRefGoogle Scholar
  4. 4.
    Desmet VJ (1999) Embryology of the liver and intrahepatic biliary tract, and an overview of malformations of the bile duct. In: Bircher J, Benhamou J-P, McIntyre N, Rizzetto M, Rhodes J (eds) The Oxford textbook of clinical hepatology, 2nd edn. Oxford University Press, Oxford, pp 51–61Google Scholar
  5. 5.
    Fasel JH, Schenk A (2013) Concepts for liver segment classification: neither old ones nor new ones, but a comprehensive one. J Clin Imaging Sci 3:48CrossRefGoogle Scholar
  6. 6.
    Hammar JA (1926) Uber die erste Entstehung der nicht kapillarenintrahepatischen Gallengange beim Menschen. Z Mikrosk AnatForsch 5:59–89Google Scholar
  7. 7.
    Hisatsugu T, Yamamoto H, Igimi H, Konomi K, Hurusawa T, Jimi M (1974) Anomaly of bile duct including aberrant right hepatic duct with cholecystolithiasis. Rinshou Seijinbyou (J Adult Dis) 4:581–586 (in Japanese) Google Scholar
  8. 8.
    Hjortsjo CH (1951) The topography of the intrahepatic duct systems. Acta Anat (Basel) 11:599–615CrossRefGoogle Scholar
  9. 9.
    Hugh TB (2002) New strategies to prevent laparoscopic bile duct injury: surgeons can learn from pilots. Surgery 132:826–835CrossRefGoogle Scholar
  10. 10.
    Ishii H, Noguchi A, Fukami T, Sugimoto R, Tada H, Takeshita H, Umehara S, Izumi H, Tani N, Yamaguchi M, Yamane T (2017) Preoperative evaluation of accessory hepatic ducts by drip infusion cholangiography with CT. BMC Surg 17:52–57CrossRefGoogle Scholar
  11. 11.
    Kitami M, Takase K, Murakami G, Ko S, Tsuboi M, Saito H, Higano S, Nakajima Y, Takahashi S (2006) Types and frequencies of biliary tract variations associated with a major portal venous anomaly: analysis with multi-detector row CT cholangiography. Radiology 238:156–166CrossRefGoogle Scholar
  12. 12.
    Kogure K, Kuwano H, Fujimaki N, Ishikawa H, Takada K (2002) Reproposal for Hjortsjo’s segmental anatomy on the anterior segment in human liver. Arch Surg 137:1118–1124CrossRefGoogle Scholar
  13. 13.
    Kurata M, Honda G, Okuda Y, Kobayashi S, Sakamoto K, Iwasaki S, Chiba K, Tabata T, Kuruma S, Kamisawa T (2015) Preoperative detection and handling of aberrant right posterior sectoral hepatic duct during laparoscopic cholecystectomy. J Hepatobiliary Pancreat Sci 22:558–562CrossRefGoogle Scholar
  14. 14.
    Lau WY, Lai EC, Lau SH (2010) Management of bile duct injury after laparoscopic cholecystectomy: a review. ANZ J Surg 80:75–81CrossRefGoogle Scholar
  15. 15.
    Ohkubo M, Nagino M, Kamiya J, Yuasa N, Oda K, Arai T, Nishio H, Nimura Y (2004) Surgical anatomy of the bile ducts at the hepatic hilum as applied to living donor liver transplantation. Ann Surg 239:82–86CrossRefGoogle Scholar
  16. 16.
    Roskams T, Desmet V (2008) Embryology of extra- and intrahepatic bile ducts, the ductal plate. Anat Rec Adv Integr Anat Evolut Biol 291:628–635CrossRefGoogle Scholar
  17. 17.
    Schnelldorfer T, Sarr MG, Adams DB (2012) What is the duct of Luschka? A systematic review. J Gastrointest Surg 16:656–662CrossRefGoogle Scholar
  18. 18.
    Spanos CP, Syrakos T (2006) Bile leaks from the duct of Luschka (subvesical duct): a review. Langenbecks Arch Surg 391:441–447CrossRefGoogle Scholar
  19. 19.
    Tan CE, Moscoso GJ (1994) The developing human biliary system at the porta hepatis level between 11 and 25 weeks of gestation: a way to understanding biliary atresia. Part 2. Pathol Int 44:600–610CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  • Shallu Garg
    • 1
  • Hemanth Kumar
    • 2
  • Daisy Sahni
    • 1
    Email author
  • T. D. Yadav
    • 2
  • Anjali Aggarwal
    • 1
  • Tulika Gupta
    • 1
  1. 1.Department of AnatomyPostgraduate Institute of Medical Education and ResearchChandigarhIndia
  2. 2.Department of General SurgeryPostgraduate Institute of Medical Education and ResearchChandigarhIndia

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