Variations of Biliary Anatomy from the Caudate Lobe by CT Cholangiography – How far can we evaluate?

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Congress:

ECR 2017

Poster Number:

C-0480

Type:

Scientific Exhibit

Keywords:

Cholangiography, CT, Liver, Biliary Tract / Gallbladder, Anatomy, Education and training

Authors:

H. Edo, R. Sekiguchi, A. Kajiyama, M. Iwasaki, M. Hasegawa, M. Tsunoo, M. Nagamoto, T. Gomi; Tokyo/JP

DOI:

10.1594/ecr2017/C-0480

DOI-Link:

https://dx.doi.org/10.1594/ecr2017/C-0480

Fig. 1: The depiction rate of the caudate branch detected by CT cholangiography. More...

Fig. 2: A 66 year-old woman with 4 branches (yellow arrow) detected from the caudate...

Table 1: Table showing the confluence ratio from the caudate branch. RHD: Right hepatic...

Fig. 3: The number of ducts of each confluence variation of the caudate branch. RHD:...

Fig. 4: Schematic diagrams of the frontal projection. The Spiegel lobe is the...

Fig. 5: The confluence pattern of the bile ducts originating from the Spiegel lobe.

Fig. 6: The confluence pattern of the bile ducts originating from the paracaval portion.

Fig. 7: The confluence pattern of the bile ducts originating from the caudate process.

Fig. 8: The origin of the bile ducts and their confluence patterns.

Results

Depiction ability and Biliary Tract Variations in Caudate Lobe

CT cholangiography detected a total of 346 bile ducts from the caudate lobe in 186 cases. Zero to 4 caudate branches was detected per person (Figure1, 2). Caudate branches were detected in 98.9% (186/188 cases).

Biliary Tract Variations from the Caudate Lobe

The bile ducts from the caudate lobe joined the left hepatic duct in 42.8% (148 ducts), the right posterior duct in 25.7% (89 ducts), the right hepatic duct in 21.4% (74 ducts), B2 in 3.5% (12 ducts), B6 in 2.3% (8 ducts), the right anterior duct in 1.7% (6 ducts), common hepatic duct in 1.7% (6 ducts) and at the confluence of hepatic ducts in 0.9% (3 ducts) (Table 1, Figure 3, 8).

Biliary Tract Variations in three portions of the Caudate Lobe

The caudate lobe is divided into three areas based on the portal blood supply: the Spiegel lobe, the paracaval portion and the caudate process [4, 5] (Figure 4).

The origin of the bile ducts were, the Spiegel lobe (199 ducts), the paracaval portion (60 ducts), and the caudate process (87 ducts).

The bile ducts from the Spiegel lobe joined the left hepatic duct in 54.8% (109 ducts), the right posterior duct in 12.1% (24 ducts), the right hepatic duct in 20.1% (40 ducts), B2 in 6% (12 ducts), B6 in 0.5% (1 ducts), the right anterior duct in 2.5% (5 ducts), common hepatic duct in 2.5% (5 ducts), and at the confluence of hepatic ducts in 1.5% (3 ducts) (Figure 5).

The bile ducts from the paracaval portion joined the left hepatic duct in 43.3% (26 ducts), the right posterior duct in 28.3% (17 ducts) and the right hepatic duct in 28.3% (17 ducts) (Figure 6).

The bile ducts from the caudate process joined the left hepatic duct in 14.9% (13 ducts), the right posterior duct in 55.2% (48 ducts), the right hepatic duct in 19.5% (17 ducts), B6 in 8.1% (7 ducts), the right anterior duct in 1.2% (1 ducts) and common hepatic duct in 1.2% (1 ducts) (Figure 7).