Clinical Evaluation of the Point of the Cystic Duct

Shoji Uetsuji, Manabu Yamamura, Yoshinori Okuda, Keigo Yamamichi, Osamu Yamada, Toshiyuki Minoura, Yoshinori Hamada, Masakatsu Yamamoto

Department of Surgery, Kansai Medical University

The clinical evaluation of the point of junction of the cystic duct with the common hepatic duct by various cholangiographic procedures including an intraoperative one and by operative findings was performed in 428 surgical patents with biliary disease. A cystic duct inserted very low down with a correspondingly long cystic duct was found in 24 cases and the clinical significance of this abnormality was investigated by comparing these patients with 300 patients with cholelithiasis without low junction of the cystic duct. In the patients with low junction of the cystic duct to form a short common bile duct, several complications including gallstone pancreatitis (6 cases), Mirizzi syndrome (6), Confluence stone (2), gallbladder cancer (2), and congenital dilatation of the cystic duct (1) were found preoperatively. The anatomically anomalous junction of the cystic duct with the common bile duct may cause stagnation of bile and/or reflux of pancreatic juice into the bile duct and cause a condition similar to the anomalous arrangement of the choledocho-pancreatic ductal junction and also may result in difficulties at surgery.

Key words
low junction of the cystic duct, anomalous arrangement of choledocho-pancreatic ductal junction, Mirizzi syndrome, confluence stone, gallbladder cancer

Reprint requests
Shoji Uetsuji Department of Surgeyr, Kanasai Medical University
1 Fumizono, Moriguchi, 570 JAPAN

Accepted
April 11, 1990

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