title: Three-dimensional reconstruction of biliary tract using spiral computed tomography for laparoscopic cholecystectomy.
abstract: To increase the safety of laparoscopic cholecystectomy, we have analyzed the biliary tract in a three-dimensional fashion. The union of the biliary ducts was studied in 50 patients using spiral computed tomography (CT) after intravenous infusion cholangiography. Depending on the union and course of the cystic duct to the common bile duct, cystic duct anatomy was classified into six categories: ipsilateral gallbladder side (type I) and contralateral side with anterior course (type II); contralateral side with posterior course (type III); intrahepatic side (type IV); intrapancreatic side (type V); and unclassified (type VI). The length of the cystic duct was also determined. The cystic duct was identified in 42 cases (84%); 30 cases (60%) were type I, 9 cases (18%) type III, and a single case (2%) of types II, IV and V, respectively. The length of the cystic duct was < or =2 cm in 30 cases that had a shorter operating time compared to 12 cases with a cystic duct <2 cm (p <0.01). In conclusion, three-dimensional reconstruction of the cystic duct anatomy using spiral CT provides simple classification of bile duct anatomy, and this preoperative information may increase the safety of laparoscopic cholecystectomy.
authors.affiliation: Department of Surgery, Tabata Gastrointestinal Hospital, 111-1 Ohkubo-cho Morita, Akashi, Hyogo 674-0061, Japan.
authors.forename: Hirohito
authors.initials: H
authors.lastname: Ichii
authors.forename: Moriatsu
authors.initials: M
authors.lastname: Takada
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Kashiwagi
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Sakane
authors.forename: Fumihira
authors.initials: F
authors.lastname: Tabata
authors.forename: Yonson
authors.initials: Y
authors.lastname: Ku
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fujimori
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kuroda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001659:Biliary Tract / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D003549:Cystic Duct / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods*