Cystic duct with medial spiral insertion: A case report

  • Ilija Golubovic Klinika za digestivnu hirurgiju, Univerzitetski klinički centar Niš
  • Sonja Golubović Center for Radiology, University Clinical Center Nis, 18000 Nis, Serbia
  • Miroslav Stojanović Clinic for Digestive Surgery, University Clinical Center Nis, 18000 Nis, Serbia
Keywords: cystic duct, anatomical variations, magnetic resonance cholangiopancreatography

Abstract


Introduction: The biliary system is well known for its anatomical variability. Precise imaging and evaluation of the cystic duct are essential for surgeons and interventional radiologists.

Case report: We reported a rare case of cystic duct variation. Coronal oblique 3D magnetic resonance cholangiopancreatography (MRCP) showed posterior spiral course of cystic duct with medial spiral insertion to the mid part of the extrahepatic bile duct. Intraoperative cholangiogram also confirms the finding.

Conclusion: Specific anatomical variations might require modifications to the surgical approach. Understanding cystic duct anatomy, variants, and disease processes aids in better diagnosis and interpretation of imaging results. MRCP is essential in giving important information on cystic duct anatomy and helps in preparing for and reducing the risk of complications during percutaneous, endoscopic, and surgical procedures.

References

1. K Kashyap R, Bozorgzadeh A, Abt P, et al. Stratifying risk of biliary complications in adult living donor liver transplantation by magnetic resonance cholangiography. Transplantation 2008;85:1569-72.

2. Fujimoto N, Tomimaru Y, Yamamoto T, et al. Clinical investigation of the cystic duct variation based on the anatomy of the hepatic vasculature. Surg Today 2020;50:396-401.

3. Netter FH. The Ciba collection of medical illustrations. Digestive system. Part III. Liver, biliary tract and pancreas. Summit: Ciba Pharmaceutical 1957;22–24.

4. KC S, Banjade UR, Ghimire P. Anatomical variations of the cystic duct assessed by magnetic resonance cholangiopancreatography (MRCP): a cross-sectional study at tertiary center of Nepal. J Patan Acad Health Sci 2024;11:15-20.
5. Miron A, Popa LG, Toma EA, et al. The Curious Case of the Choledochal Cyst-Revisiting the Todani Classification: Case Report and Review of the Literature. Diagnostics (Basel) 2023;13:1059.

6. Jan RU, Shah SG, Shah AA, et al. Frequency of various anatomical variation of the cystic duct in patients with Cholelithiasis: A Descriptive Study. JPTCP 2023;30:1008-13.

7. Sarawagi R, Sundar S, Gupta SK, et al. Anatomical Variations of Cystic Ducts in Magnetic Resonance Cholangiopancreatography and Clinical Implications. Radiol Res Pract 2016;2016:3021484.
Published
2025/11/19
Section
Prikaz slučaja / Case report