A study of the anatomic variations of the pancreatico-biliary system in Palestine: a national study

Abstract

Background: The objective of this study is to assess the frequency of anatomic variations of the biliary system in the Palestinian population in patients undergoing MRCPs.Methods: For a period of 3 years, from March 2016 to January 2019, a total of 401 MRCPS were performed in different Palestinian Medical Centers for different indications. 346 Images were included in the study. Images were evaluated independently by two expert radiologists for the presence of variations in the anatomy of gallbladder, cystic duct, common bile duct, pancreatic duct, pancreas and intrahepatic ducts.Results: About 78% of the images had normal anatomy of Intra-hepatic ducts. Right posterior duct joining the right anterior duct by its lateral side was observed in 12.6% of images and triple confluence in 8.5% of images. About 12% of the gallbladder images have anatomical variation; multi-septate in 4.1% of images and ectopic in 3.7% images. For the cystic duct, it was abnormally low in 9.6% of images and high in 5.3% of images. The cystic duct was found parallel in 2.3% of images. Variations of the pancreatic duct were evident in 3.9% of the images.Conclusions: anatomical variations of the pancreatico-biliary system are common and they are worth the attention to prevent major complications during hepatobiliary surgeries.