Olmedo Norman B, Dos Santos José Sebastião, Junior Jorge Elías
Department of Imaging and Radiology, College of Medical Sciences, Central University of Ecuador, Quito, ECU.
Department of Surgery and Anatomy, Hospital das Clinicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, BRA.
Cureus. 2024 Apr 24;16(4):e58905. doi: 10.7759/cureus.58905. eCollection 2024 Apr.
Complications arising from hepatobiliary surgery can have adverse effects on both the quality of life and the survival of patients. Magnetic resonance cholangiography (MRC) techniques are highly effective at revealing anatomical variants of the bile ducts and thus play a vital role in minimizing the occurrence of complications. The aims of this review are threefold: to ascertain the classifications utilized for categorizing anatomical variants of the bile ducts, to present the reported results on the prevalence of these anatomical variants, and to explore the diagnostic modalities employed to visualize these anatomical variants and associated complications during surgical procedures. A review of the literature was carried out using the Cochrane Library database and the PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), and Google Scholar platforms. We conducted a comprehensive review of relevant studies to categorize the different anatomical variants according to the Huang classification. According to the Huang classification, our study showed type A1, 60.44%; type A2, 11.76%; type A3, 11.73%; type A4, 5.47%; type A5, 0.26%; and type B, which was identified in insignificant numbers (0.16%) or does not appear; additionally, variants that do not fit into the Huang classification have also been identified (10.18%). The Huang classification serves as an invaluable presurgical guide, aiding in the strategic planning of biliary interventions and effectively reducing the risk of iatrogenic complications, morbidity, mortality, and postoperative length of stay. MRC is still considered the noninvasive gold standard method for evaluating the bile ducts and their anatomical variations.
肝胆外科手术引起的并发症会对患者的生活质量和生存率产生不利影响。磁共振胆管造影（MRC）技术在揭示胆管解剖变异方面非常有效，因此在减少并发症的发生方面起着至关重要的作用。本综述的目的有三个：确定用于对胆管解剖变异进行分类的分类方法，呈现这些解剖变异发生率的报告结果，并探讨在手术过程中用于可视化这些解剖变异及相关并发症的诊断方法。使用Cochrane图书馆数据库、PubMed、医学文献分析与检索系统在线（MEDLINE）以及谷歌学术平台对文献进行了综述。我们对相关研究进行了全面回顾，以根据黄氏分类法对不同的解剖变异进行分类。根据黄氏分类法，我们的研究显示A1型占60.44%；A2型占11.76%；A3型占11.73%；A4型占5.47%；A5型占0.26%；B型数量极少（0.16%）或未出现；此外，还发现了不符合黄氏分类法的变异（10.18%）。黄氏分类法是一种非常有价值的术前指南，有助于胆管干预的战略规划，并有效降低医源性并发症、发病率、死亡率和术后住院时间的风险。MRC仍然被认为是评估胆管及其解剖变异的无创金标准方法。
