ArticleSurgical and radiologic anatomy : SRA2024
Variations in the cystic duct: frequency and the relationship among insertion sides and heights on the bile duct.
Article in Surgical and radiologic anatomy : SRA, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.
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Who cites it
3 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A cautionary tale of anatomical variations of the extrahepatic biliary system and their implications for surgical procedures: a systematic literature review.Surgical and radiologic anatomy : SRA · 2025Pooled it
- Intraoperative Variations of Cystic Artery and Duct in Laparoscopic Cholecystectomy: A Systematic Review With Meta-Analysis.ANZ journal of surgeryPooled it
- Anatomical Considerations for Biliary Interventions: Navigating Challenging Cases.Seminars in interventional radiology · 2025Review
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundEvaluation of the cystic duct anatomy prior to bile duct or gallbladder surgery is important, to decrease the risk of bile duct injury. This study aimed to clarify the frequency of cystic duct variations and the relationship between them.
methodsData of 205 patients who underwent cholecystectomy after imaging at Sada Hospital, Japan, were analyzed. The Chi-square test was used to analyze the relationships among variations.
resultsThe lateral and posterior sides of the bile duct were the two most common insertion points (92 patients, 44.9%), and the middle height was the most common insertion height (135 patients, 65.9%). Clinically important variations (spiral courses, parallel courses, low insertions, and right hepatic duct draining) relating to the risk of bile duct injury were observed in 24 patients (11.7%). Regarding the relationship between the insertion sides and heights, we noticed that the posterior insertion frequently existed in low insertions (75.0%, P < 0.001) and did not exist in high insertions. In contrast, the anterior insertion coexisted with high and never low insertions. Spiral courses have two courses: anterior and posterior, and anterior ones were only found in high insertion cases.
conclusionsThe insertion point of the cystic duct and the spiral courses tended to be anterior or lateral superiorly and posterior inferiorly. Clinically significant variations in cystic duct insertions are common and surgeons should be cautious about these variations to avoid complications.
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