The Morphological Aberrations of Cystic Duct and its Clinical Significance: A Gross Anatomical Study

Introduction: The Cystic Duct (CD) serves as a thorough fare for transport of bile to and away from the gallbladder. It is about 2-4 cm in length and 1-5 mm in diameter, and joins the Common Hepatic Duct (CHD) at its right lateral aspect, in the middle third to form the Common Bile Duct (CBD). A large number of variations are seen in its anatomy which is either due to aberrations during its developmental process or a result of underlying pathology. Aim: To study the length, diameter, course, site and level of insertion of the CD. Presence of any other anomaly was also looked into. Materials and Methods: This study was undertaken on one hundred specimens of liver along with entire extra hepatic biliary apparatus, in the Department of Anatomy, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, and Subharti Medical College, between 2008 to 2013. Total 100 cadavers considered for the study. The morphology of CD was studied with respect to its length, mid length diameter, course, site and level of insertion and the presence of other anomalies Results: In 99 (99%) specimens the CD joined the CHD and in one (1%) it joined the Right Hepatic Duct (RHD). The length of the CD was found between 0.2 cm to 6.2 cm. The mid-length diameter of the CD ranged from 0.2 cm-0.8 cm. The course of CD was angular in 53 (53%), parallel in 23 (23%), spiral in 24 (24%) specimens. The site of insertion in 76 (76%) specimens, was right lateral, in 4 (4 %) it was anterior, in 15 (15%) it was posterior and in 5 (5%) was left medial. A tubular channel was seen arising from the wall of the gallbladder and draining into CHD above the opening of the usual one. Conclusion: Important variations were found which are significant from the surgical point of view, especially as there is a surge in laparoscopic cholecystectomies and other minimally invasive procedures in the recent era.