ANATOMICAL VARIATIONS OF THE EXTRAHEPATIC BILIARY APPARATUS AND THEIR CLINICAL SIGNIFICANCE
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Keywords
Extrahepatic biliary apparatus, Gall bladder, bile duct, hepatic duct
Abstract
Background: Anatomical variations of the extrahepatic biliary apparatus (EHBA) are clinically important because they can pose diagnostic challenges and lead to iatrogenic injuries during hepatobiliary surgery. Regional morphometric data remain valuable for improving surgical safety and radiological interpretation.
Objectives: To document the gross anatomical variations of the gallbladder and EHBA in adult cadaveric specimens and to assess their clinical relevance.
Materials and Methods: A descriptive cross-sectional cadaveric study was conducted on 100 adult specimens obtained from the Indore region. Gross anatomical parameters of the gallbladder, including length, breadth, wall thickness, and shape, were examined. The EHBA was evaluated for the configuration of the hepatoduodenal ligament, cystic duct–common hepatic duct junction, level of cystic duct termination, accessory ducts, cystic artery variations, and the boundaries of Calot’s triangle.
Results: Gallbladder length showed marked variability, with a mean of 8.81 ± 1.47 cm; most specimens measured between 7–10 cm. The transverse breadth was relatively consistent (mean 3.92 ± 0.81 cm). Wall thickness varied regionally, with the neck being thinner than the fundus and body. The pear-shaped gallbladder was predominant (87%), though several morphological variants were identified. An angular cystic duct–CHD junction was most common (87%), and high termination of the cystic duct was observed in 11% of specimens. Accessory ducts and vascular variations were infrequent but notable, and Calot’s triangle was well defined in the majority of cases.
Conclusion: The study confirms that anatomical variations of the gallbladder and EHBA are common and clinically significant. Awareness of these variations, supported by careful preoperative imaging and meticulous surgical technique, is essential to minimize operative complications and improve outcomes in hepatobiliary procedures.
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All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Aashish Kumar Shah
Ph.D Scholar, Dept. of Anatomy, Malwanchal university, Indore
Dr.Pawan Kumar Mahato
Professor, Dept. of Anatomy, SSIMS, Bhilai (CG)
Dr. Rajendra singh
Assistant Professor, Dept of Anatomy, IMCH&RC,
