Department of General Surgery, Kanuni Sultan Suleyman Training & Research Hospital, Health Science University, Istanbul, Turkey.
Department of Radiology, Kanuni Sultan Suleyman Training & Research Hospital, Health Science University, Istanbul, Turkey.
J Coll Physicians Surg Pak. 2022 Aug;32(8):991-995. doi: 10.29271/jcpsp.2022.08.991.
To evaluate the anatomy of the extrahepatic bile duct and to reveal its importance in the formation of acute calculous cholecystitis (ACC).
Case-control study.
Department of General Surgery and Radiology, Kanuni Sultan Suleyman Training and Research Hospital of the University of Health Sciences, Turkey, between January 2016 and December 2021.
The data of the patients treated with ACC were analysed on MRCP by an experienced radiologist. The patients were divided into two groups; asymptomatic gallstones (AsGS, control group) and ACC. The cystic duct, common hepatic duct, and common bile duct lengths and variations in cystic duct opening were measured. Receiver operating characteristics (ROC) analysis was conducted to define a cut-off value and compared categorical results of the two groups by Mann-Whitney U test.
One-hundred and seventy-three patients were analysed, one-hundred and seven were females, and 66 were males. The median age was 46 years in the AsGS group and 53 years in the ACC group. It was statistically significant that ACC had a higher median age value than AsGS (p=0.014). In the analysis of extrahepatic variations, cystic duct, common hepatic duct, and common bile duct length, were statistically longer in the calculous cholecystitis group (p<0.001, p=0.022, and p=0.019 respectively). ROC analysis was performed for cystic, common hepatic, and common bile duct length, respectively. Cut-off values were 30.5 mm, 36.5 mm, and 42.5 mm.
Extrahepatic bile duct variations are of critical importance in ACC surgery. In the data, as the cystic duct and common bile duct lengthens, the possibility of ACC increases. There is need for studies with larger samples.
Acute calculous cholecystitis, Extrahepatic biliary tract, Anatomical variations, Cholelithiasis.
评估肝外胆管解剖结构，揭示其在急性结石性胆囊炎（ACC）形成中的重要性。
病例对照研究。
土耳其健康科学大学 Kanuni Sultan Suleyman 培训与研究医院普外科和放射科，2016 年 1 月至 2021 年 12 月。
由一位有经验的放射科医生对接受 ACC 治疗的患者的 MRCP 数据进行分析。将患者分为两组：无症状胆囊结石（AsGS，对照组）和 ACC。测量胆囊管、肝总管和胆总管的长度以及胆囊管开口的变化。进行受试者工作特征（ROC）分析以定义一个截断值，并通过 Mann-Whitney U 检验比较两组的分类结果。
共分析了 173 例患者，其中 107 例为女性，66 例为男性。AsGS 组的中位年龄为 46 岁，ACC 组的中位年龄为 53 岁。ACC 的中位年龄值明显高于 AsGS（p=0.014），这具有统计学意义。在肝外变异分析中，胆囊管、肝总管和胆总管长度在结石性胆囊炎组中明显更长（p<0.001、p=0.022 和 p=0.019）。分别对胆囊管、肝总管和胆总管长度进行 ROC 分析。截断值分别为 30.5mm、36.5mm 和 42.5mm。
肝外胆管变异在 ACC 手术中至关重要。在数据中，随着胆囊管和胆总管的延长，ACC 的可能性增加。需要进行具有更大样本量的研究。
急性结石性胆囊炎；肝外胆管；解剖变异；胆石症。
