Morphometric examination of the hepatobiliary duct system in healthy individuals and patients with cholelithiasis: A radio-anatomic magnetic resonance cholangiopancreatography study
Year 2023,
Volume: 48 Issue: 2, 706 - 714, 02.07.2023
Şeyma Toy
,
Deniz Şenol
,
Rukiye Çiftçi
,
Serkan Sevgi
,
Yusuf Seçgin
,
İsmail Okan Yıldırım
Abstract
Purpose: Cholelithiasis is a common gallbladder disease with high morbidity and treatment cost. Although the disease has many formation factors such as bile duct obstruction, congenital anomalies, genetic and metabolic diseases, the main cause is gallstones. The aim of this study is to examine the radio-anatomic and demographic characteristics of the bile ducts of patients who have cholelithiasis due to gallstones by using magnetic resonance cholangiopancreatography (MRCP) and to compare with healthy individuals.
Materials and Methods: The study was carried out by retrospectively scanning the MRCP images of 113 patients diagnosed with cholelithiasis and 87 healthy individuals who were referred to the hospital for various indications and had no gallbladder pathology.
Results: According to the Spearman rho correlation test performed by ignoring gender, a significant correlation was found between right hepatic duct diameter (RHD-D) and right hepatic duct – cystic duct angle (RHDCD-A), and between left hepatic duct diameter (LHD-D) and common bile duct diameter (CBD-D). In the correlation analysis performed only among males, a significant correlation was found between RHDCD-A and right hepatic duct – left hepatic duct angle (RLHD-A), RHDCD-A and common hepatic duct diameter (CHD-D) parameters. In the correlation analysis performed only among women, a significant relationship was found between age and RHD-D, LHD-D, CHD-D, CBD-D, between RHDCD-A and cystic duct – gallbladder angle (CDG-A), RHD-D, and between CHD-D and cystic duct diameter (CD-D).
Conclusion: This study will contribute to literature by revealing the morphometric characteristics and radio- anatomic information of the hepatobiliary systems of both patients with cholelithiasis and healthy individuals.
Thanks
I would like to thank the team of authors who contributed to the creation of the study.
References
- Zarate A, Torrealba A, Patiño B, Alvarez M, Raue M. Colelitiasis: obtenido de manual de enfermedades digestivas quirúrgicas. UCR-HSJD. 2017:1-6.
- Palermo M, Berkowski DE, Córdoba JP, Verde JM, Giménez ME. Prevalence of cholelithiasis in Buenos Aires, Argentina. Acta Gastroenterol. Latinoam. 2013;43:98-105.
- Portincasa P, Ciaula AD, Bonfrate L, Wang DQ. Therapy of gallstone disease: what it was, what it is, what it will be. World J Gastrointest Pharmacol Ther. 2012;3:7-20.
- Duncan CB, Riall TS. Evidence-based current surgical practice: calculous gallbladder disease. J Gastrointest Surg. 2012;16:2011-25.
- Wang HH, Portincasa P, de Bari O, Liu KJ, Garruti G, Brent A, Tetri N et al. Prevention of cholesterol gallstones by inhibiting hepatic biosynthesis and intestinal absorption of cholesterol. Eur J Clin Invest. 2013;43:413-26.
- Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long Term Eff Med Implants. 2005;15:329-38.
- Scherber PR, Zuniga SE, Glanemann M, Lammert F. Gallstone disease - interdisciplinary treatment. Dtsch Med Wochenschr. 2020;145:287-95.
- Buchner AM, Sonnenberg A. Factors influencing the prevalence of gallstones in liver disease: the beneficial and harmful influences of alcohol. Am. J. Gastroenterol. 2002;97:905-9.
- Lee JY, Keane MG, Pereira S. Diagnosis and treatment of gallstone disease. Practitioner. 2015;259:15-9.
- Gore JM. Cholelithiasis. JAAPA. 2013;26:54-5.
- Akat AZ, Doğanay M, Koloğlu M, Gözalan U, Dağlar G, Kama NA. Tek merkezde yapılan 1000 vakada laparoskopik kolesistektominin değerlendirilmesi. Türkiye Klinikleri J Health Sci. 2002;22:133-41.
- Littlefield A, Lenahan C. Cholelithiasis: presentation and management. JMWH. 2019;64:289-97.
- Hanbidge AE, Buckler PM, O'Malley ME, Wilson SR. From the RSNA refresher courses: imaging evaluation for acute pain in the right upper quadrant. Radiographics. 2004;24:1117-35.
- Nakeeb A, Comuzzie AG, Martin L, Sonnenberg G, Swartz-Basile D, Kissebah A, et al. Gallstones: genetics versus environment. Ann Surg. 2002;235:842-9.
- Arık Mk, Türk N, Süner A. The incidance of metabolic in patients with operation for gallbladder. MEDJ. 2010;25:158-63.
- Taylor EL, Jr., Harrington TM. Cholecystitis and cholelithiasis. Prim Care. 1988;15:147-56.
- Moro PL, Checkley W, Gilman RH, G Lescano, J J Bonilla, B Silva, et al. Gallstone disease in high-altitude peruvian rural populations. Am. J. Gastroenterol. 1999;94:153-8.
- Jørgensen T. Prevalence of gallstones in a danish population. AJE. 1987;126:912-21.
- Ulubaba He, Kirhan İ, Çiftçi R. A Rare Congenital biliary anomaly: anomalous pancreaticobiliary junction. Med. Records. 2021;3:154-6.
- Aguiar JA, Riaz A, Thornburg B. Biliary anatomy. Semin Intervent Radiol. 2021;38:251-4.
- Kurelli SCG, Wang J, Abbas S, Kanduri HK, Liu W. Hepatobiliary and hepatic vascular anatomy evaluated with computed tomography and magnetic resonance imaging: the current status. Radiol. Infect. Dis. 2020;7:1-6.
- Valkovic P, Miletic D, Zelic M, Brkljacic B. Dynamic changes in the common bile duct after laparoscopic cholecystectomy: a prospective longitudinal sonographic study. Ultraschall Med. 2011;32:479-84.
- Karataş T, Özbağ D, Ögetürk M, Demirtas G, Senol D, Cevirgen F, et al. Evaluation of morphometry in extrahepatic bile ducts in preoperative and postoperative periods in diabetic and non-diabetic patients with cholelithiasis. Ann Med Res. 2020;27:2191-5
Sağlıklı bireylerde ve kolelitiazisli hastalarda hepatobiliyer kanal sisteminin morfometrik incelenmesi: Bir radyo-anatomik manyetik rezonans kolanjiyopankreatografi çalışması
Year 2023,
Volume: 48 Issue: 2, 706 - 714, 02.07.2023
Şeyma Toy
,
Deniz Şenol
,
Rukiye Çiftçi
,
Serkan Sevgi
,
Yusuf Seçgin
,
İsmail Okan Yıldırım
Abstract
Amaç: Kolelitiazis, morbiditesi ve tedavi maliyeti yüksek, sık görülen bir safra kesesi hastalığıdır. Hastalığın safra kanalı tıkanıklıkları, doğumsal anomaliler, genetik ve metabolik hastalıklar gibi birçok oluşum faktörü bulunsa da asıl nedeni safra taşlarıdır. Bu çalışmanın amacı safra taşı nedeniyle kolelitiazis gelişen hastaların safra yollarının radyo-anatomik ve demografik özelliklerini manyetik rezonans kolanjiyopankreatografi (MRCP) ile incelemek ve sağlıklı bireylerle karşılaştırmaktır.
Gereç ve Yöntem: Çalışma kolelitiazis tanısı alan 113 hasta ile çeşitli endikasyonlarla hastaneye başvuran ve safra kesesi patolojisi olmayan 87 sağlıklı bireyin MRCP görüntülerinin retrospektif olarak taranmasıyla gerçekleştirildi.
Bulgular: Cinsiyet dikkate alınmadan yapılan Spearman rho korelasyon testine göre sağ hepatik kanal çapı (RHD-D) ile sağ hepatik kanal – sistik kanal açısı (RHDCD-A) arasında ve sol hepatik kanal çapı (LHD-D) ve ductus choledochus kanal çapı (CBD-D) arasında anlamlı bir korelasyon bulundu. Sadece erkekler arasında yapılan korelasyon analizinde RHDCD-A ile sağ hepatik kanal – sol hepatik kanal açısı (RLHD-A), RHDCD-A ve ductus hepaticus communis kanal çapı (CHD-D) parametreleri arasında anlamlı bir korelasyon bulundu. Sadece kadınlarda yapılan korelasyon analizinde yaş ile RHD-D, LHD-D, CHD-D, CBD-D arasında, RHDCD-A ile sistik kanal – safra kesesi açısı (CDG-A), RHD-D arasında ve CHD-D and cystic duct diameter (CD-D) arasında anlamlı bir ilişki bulunmuştur.
Sonuç: Bu çalışmanın hem kolelitiazisli hastaların hem de sağlıklı bireylerin hepatobiliyer kanal sistemlerinin morfometrik özelliklerini ve radyoanatomik bilgilerini ortaya koyarak literatüre katkı sağlayacağına inanıyoruz.
References
- Zarate A, Torrealba A, Patiño B, Alvarez M, Raue M. Colelitiasis: obtenido de manual de enfermedades digestivas quirúrgicas. UCR-HSJD. 2017:1-6.
- Palermo M, Berkowski DE, Córdoba JP, Verde JM, Giménez ME. Prevalence of cholelithiasis in Buenos Aires, Argentina. Acta Gastroenterol. Latinoam. 2013;43:98-105.
- Portincasa P, Ciaula AD, Bonfrate L, Wang DQ. Therapy of gallstone disease: what it was, what it is, what it will be. World J Gastrointest Pharmacol Ther. 2012;3:7-20.
- Duncan CB, Riall TS. Evidence-based current surgical practice: calculous gallbladder disease. J Gastrointest Surg. 2012;16:2011-25.
- Wang HH, Portincasa P, de Bari O, Liu KJ, Garruti G, Brent A, Tetri N et al. Prevention of cholesterol gallstones by inhibiting hepatic biosynthesis and intestinal absorption of cholesterol. Eur J Clin Invest. 2013;43:413-26.
- Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long Term Eff Med Implants. 2005;15:329-38.
- Scherber PR, Zuniga SE, Glanemann M, Lammert F. Gallstone disease - interdisciplinary treatment. Dtsch Med Wochenschr. 2020;145:287-95.
- Buchner AM, Sonnenberg A. Factors influencing the prevalence of gallstones in liver disease: the beneficial and harmful influences of alcohol. Am. J. Gastroenterol. 2002;97:905-9.
- Lee JY, Keane MG, Pereira S. Diagnosis and treatment of gallstone disease. Practitioner. 2015;259:15-9.
- Gore JM. Cholelithiasis. JAAPA. 2013;26:54-5.
- Akat AZ, Doğanay M, Koloğlu M, Gözalan U, Dağlar G, Kama NA. Tek merkezde yapılan 1000 vakada laparoskopik kolesistektominin değerlendirilmesi. Türkiye Klinikleri J Health Sci. 2002;22:133-41.
- Littlefield A, Lenahan C. Cholelithiasis: presentation and management. JMWH. 2019;64:289-97.
- Hanbidge AE, Buckler PM, O'Malley ME, Wilson SR. From the RSNA refresher courses: imaging evaluation for acute pain in the right upper quadrant. Radiographics. 2004;24:1117-35.
- Nakeeb A, Comuzzie AG, Martin L, Sonnenberg G, Swartz-Basile D, Kissebah A, et al. Gallstones: genetics versus environment. Ann Surg. 2002;235:842-9.
- Arık Mk, Türk N, Süner A. The incidance of metabolic in patients with operation for gallbladder. MEDJ. 2010;25:158-63.
- Taylor EL, Jr., Harrington TM. Cholecystitis and cholelithiasis. Prim Care. 1988;15:147-56.
- Moro PL, Checkley W, Gilman RH, G Lescano, J J Bonilla, B Silva, et al. Gallstone disease in high-altitude peruvian rural populations. Am. J. Gastroenterol. 1999;94:153-8.
- Jørgensen T. Prevalence of gallstones in a danish population. AJE. 1987;126:912-21.
- Ulubaba He, Kirhan İ, Çiftçi R. A Rare Congenital biliary anomaly: anomalous pancreaticobiliary junction. Med. Records. 2021;3:154-6.
- Aguiar JA, Riaz A, Thornburg B. Biliary anatomy. Semin Intervent Radiol. 2021;38:251-4.
- Kurelli SCG, Wang J, Abbas S, Kanduri HK, Liu W. Hepatobiliary and hepatic vascular anatomy evaluated with computed tomography and magnetic resonance imaging: the current status. Radiol. Infect. Dis. 2020;7:1-6.
- Valkovic P, Miletic D, Zelic M, Brkljacic B. Dynamic changes in the common bile duct after laparoscopic cholecystectomy: a prospective longitudinal sonographic study. Ultraschall Med. 2011;32:479-84.
- Karataş T, Özbağ D, Ögetürk M, Demirtas G, Senol D, Cevirgen F, et al. Evaluation of morphometry in extrahepatic bile ducts in preoperative and postoperative periods in diabetic and non-diabetic patients with cholelithiasis. Ann Med Res. 2020;27:2191-5