title: Anatomic variations of intrahepatic bile ducts in a European series and meta-analysis of the literature.
abstract: BACKGROUND
  Accurate knowledge of biliary anatomy and its variants is essential to ensure successful hepatic surgery; however, data from European countries are lacking.
  
  
  METHODS
  Two hundred cholangiograms obtained from patients submitted to whole liver transplantation were reviewed; donors' characteristics were related to the prevalence of typical biliary anatomy and its variants. A comprehensive literature search was performed with MEDLINE and EMBASE from 1980 to 2010 to investigate whether geographical origin could be related to biliary abnormalities.
  
  
  RESULTS
  Typical biliary anatomy was observed in 64.5% of cases, but female donors more frequently presented an anatomic variation; typical anatomy was present in 55.0% of females and in 74.0% of males (P = 0.005). Twenty-two reports were identified by the literature search with a total of 7,559 cases, including the present series; heterogeneity was low (Q = 14.60; I2 < 5.0%) after exclusion of three outlier reports. Prevalence of typical biliary anatomy was similar in Europeans and Americans (∼60%); a slightly higher prevalence was observed in Asiatics (∼65%).
  
  
  CONCLUSIONS
  Anatomic variants seem to be more frequent in females, probably as a consequence of different embryologic development. Available data suggest that typical biliary anatomy can be more frequent in Asiatics, but an accurate means of classification is essential to making comparison realistic.
authors.affiliation: Liver and Multiorgan Transplant Unit, University of Bologna, Bologna, Italy. aleqko@libero.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cucchetti
authors.forename: Eugenia
authors.initials: E
authors.lastname: Peri
authors.forename: Matteo
authors.initials: M
authors.lastname: Cescon
authors.forename: Matteo
authors.initials: M
authors.lastname: Zanello
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ercolani
authors.forename: Chiara
authors.initials: C
authors.lastname: Zanfi
authors.forename: Valentina
authors.initials: V
authors.lastname: Bertuzzo
authors.forename: Paolo
authors.initials: P
authors.lastname: Di Gioia
authors.forename: Antonio Daniele
authors.initials: AD
authors.lastname: Pinna
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia; D001653:Bile Ducts, Intrahepatic / Q000002:abnormalities / Q000033:anatomy & histology*; D002648:Child; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D014481:United States; D055815:Young Adult