Anomalies and Anatomic Variants of the Biliary Tract

Abstract

The recognition of the congenital anomalies and anatomic variants of the biliary tree is important in clinical practice. Currently, laparoscopic cholecystectomy and living donor liver transplantation are performed more frequently than before. The correct diagnosis of anatomic variant that may increase the risk of the bile duct injury aids in surgical planning and can prevent inadvertent complications such as inadvertent ductal ligation, biliary leaks, and ductal stricture. Furthermore, the congenital anomalies of the biliary tree may be undetected until adulthood, and an extensive work-up is undertaken before the correct diagnosis, because the symptoms and signs of the congenital anomaly are often nonspecific. Thus, in case of persistent and unexplained symptoms and signs including cholangitis, pancreatitis, jaundice, recurrent abdominal pain, nausea and vomiting, underlying congenital anomalies of the biliary tree should be considered. There are various kinds of congenital anomalies and anatomic variants involving biliary tree including aberrant or accessory biliary ducts, aberrant cystic duct insertion, choledochal cyst, and anomalous pancreaticobiliary ductal union (APBDU). Therefore, radiologists need to be familiar with these disease entities and their image features.