Al-Muhanna Asma Fahd, Lutfi Abdelhamied Mohamed, Al-Abdulwahhab Abdulrahman Hamad, Al-Sharydah Abdulaziz Mohammad, Al-Quorain Abdulaziz, Al-Muhanna Afnan Fahd, Al-Dhaferi Bander Fuhaid
Anatomy Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, P.O. Box 31952, Dammam, Eastern Province, Saudi Arabia.
Radiology Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Dammam, Eastern Province, Saudi Arabia.
Surg Radiol Anat. 2019 Aug;41(8):869-877. doi: 10.1007/s00276-019-02249-0. Epub 2019 May 2.
This study investigated biliary tree patterns in a Saudi Arabian population to identify common anatomical variations to establish a common ground for improved surgical practice and to avoid unexpected complications. We consider this type of investigation clinically important because the findings are valuable for pre-surgical planning in a broad range of procedures, including laparoscopic cholecystectomy and liver transplantation.
We conducted an imaging-based retrospective cross-sectional study involving 150 patients who underwent endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiopancreatography for different indications at King Fahd Hospital of the University between January 2011 and December 2014.
Typical right hepatic duct (RHD) tributaries were observed in 56% of patients and typical left hepatic duct (LHD) anatomy was detected in 81.4% of patients. The typical anatomical pattern for the cystic duct was found in 72% of patients.
Our findings showed that types A1 and A3b were the two most common variations in the RHD, whereas those in LHD were types B1 (segment IV duct opens to the LHD), and B2 (segment IV duct opens to the common hepatic duct separately). Although the angular type was the most prevalent among cystic duct variations, there were many differences in the types of variations observed. The findings somewhat correlated with those of other studies, suggesting that the normal biliary tree anatomy is similar among the Saudi population and in other ethnic groups.
本研究调查了沙特阿拉伯人群的胆管树模式，以识别常见的解剖变异，为改进手术操作建立共同基础，并避免意外并发症。我们认为这类研究具有临床重要性，因为研究结果对于包括腹腔镜胆囊切除术和肝移植在内的广泛手术的术前规划具有重要价值。
我们进行了一项基于影像学的回顾性横断面研究，纳入了2011年1月至2014年12月期间在法赫德国王大学医院因不同适应证接受内镜逆行胰胆管造影术和磁共振胰胆管造影术的150例患者。
56%的患者观察到典型的右肝管（RHD）分支，81.4%的患者检测到典型的左肝管（LHD）解剖结构。72%的患者发现胆囊管的典型解剖模式。
我们的研究结果表明，A1型和A3b型是RHD中最常见的两种变异，而LHD中的变异是B1型（IV段胆管开口于LHD）和B2型（IV段胆管分别开口于肝总管）。虽然角型是胆囊管变异中最常见的类型，但观察到的变异类型存在许多差异。研究结果与其他研究结果有一定相关性，表明沙特人群和其他种族群体的正常胆管树解剖结构相似。
