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Analysis of biliary anatomy according to different classification systems.
Pranjal Deka1, Mahibul Islam, Deepti Jindal
1Department of HPB Surgery, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, 110 070, India.
Summary
This study compared six biliary anatomy classification systems using magnetic resonance cholangiopancreatography. The Ohkubo classification was most applicable for identifying common bile duct variations in hepatobiliary surgery.
Area of Science:
- Radiology and Medical Imaging
- Anatomy
- Surgical Anatomy
Background:
- Biliary anatomy exhibits common variations, with multiple classification systems proposed.
- Previous studies have not comparatively analyzed these classification systems within a single patient cohort.
Purpose of the Study:
- To compare six distinct biliary anatomy classification systems.
- To report variations in biliary anatomy using magnetic resonance cholangiopancreatography (MRCP).
Main Methods:
- MRCP was performed on 299 patients.
- Biliary anatomy was classified using systems by Couinaud, Huang, Karakas, Choi, Champetier, and Ohkubo.
- Correlation with direct cholangiography, vascular anatomy, and measurement of bile duct dimensions were conducted.
Main Results:
- Normal biliary anatomy was observed in 57.8% of patients.
- The Ohkubo classification system demonstrated the highest applicability for classifying biliary variations.
- Anomalous pancreaticobiliary ductal junction (PBDJ) was identified in 8.7% of cases.
Conclusions:
- While existing classification systems have limitations, the Ohkubo system is most suitable for clinical application.
- The Ohkubo classification effectively accounts for clinically relevant biliary variations encountered in hepatobiliary surgery.
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