title: Variations of cystic duct (CD)--common hepatic duct (CHD) junction determined by ERCP.
abstract: BACKGROUND
  Cystic Duct (CD) join Common Hepatic Duct (CHD) to the right with right angle close to 75% of cases and in 25% of cases like spiral intersects the CHD from above or behind and join it to his left to form the Common Bile Duct (CBD). There are authors who describe that CD may join CHD at any level to form CBD. The importance of recognizing union of CD and CHD has significant importance for the surgeons that perform Cholecystectomy, in order to avoid injuries to the CHD or CBD.
  
  
  OBJECTIVE
  to present the variations of CD-CHD junction determined by ERCP. To recognize variations of CD-CHD junction in Albanian population used in this study. To present differences of CD-CHD junction between male and female population.
  
  
  RESULTS
  Data were taken from the protocols of ERCP that has been done in UCC of Kosova - Department of Endoscopy, Clinic of Surgery. During last 2 years period we have had 398 patients in ERCP from those we have determined CD-CHD junction on 148 (37.85%) patients. 76 were Female (51.35%) and 72 male (48.65%). CD-CHD junction was identified as right junction in 117(79.05%) patients: UR in 64(43.24%), MR in 46(31.08%), LR in 7 (4.73%). Left CD-CHD junction was identified in 31 (20.95%) of patients: UL in 4(2.70%), ML 6(4.07%) and LL in 21 (14.18%) of patients. It is important to notice that Lower Left union of CD and CHD is rare or not prescribed in literature. We haven't find significant differences between male and female groups according to right or left CD-CHD junction (p<0.05). There is deference between male and female in lower CD-CHD junction (p<0.01), and there is also deference between male and female in left lower CD-CHD junction (p<0.05).
  
  
  CONCLUSIONS
  We conclude that CD-CHD junction was identified as right junction in 79.05% patients and as left CD-CHD junction was identified in 20.95%. There is deference between male and female in left lower CD-CHD junction (p<0.01). We have identified LL CD-CHD junction in 14.18% of patients and that is rare or not prescribed in literature.
authors.affiliation: Department of Endoscopy, Clinic of Surgery, University Clinical Center of Kosova, Prishtine, Kosova. besnikbicaj@yahoo.com
authors.forename: Besnik
authors.initials: B
authors.lastname: Bicaj
authors.affiliation: Faculty of Medicine, Tirana University, Tirana, Albania.
authors.forename: Sofika
authors.initials: S
authors.lastname: Qamirani
authors.affiliation: Faculty of Medicine, Pristine University, Pristine, Kosova.
authors.forename: Flamur
authors.initials: F
authors.lastname: Blakaj
authors.affiliation: Faculty of Medicine, Pristine University, Pristine, Kosova.
authors.forename: Teuta
authors.initials: T
authors.lastname: Bicaj
authors.affiliation: Department of Endoscopy, Clinic of Surgery, University Clinical Center of Kosova, Prishtine, Kosova.
authors.forename: Valon
authors.initials: V
authors.lastname: Zejnullahu
authors.affiliation: Department of Endoscopy, Clinic of Surgery, University Clinical Center of Kosova, Prishtine, Kosova.
authors.forename: Astrit
authors.initials: A
authors.lastname: Hamza
authors.affiliation: Department of Endoscopy, Clinic of Surgery, University Clinical Center of Kosova, Prishtine, Kosova.
authors.forename: Faton
authors.initials: F
authors.lastname: Hoxha
authors.affiliation: Faculty of Medicine, Pristine University, Pristine, Kosova.
authors.forename: Sefedin
authors.initials: S
authors.lastname: Muçaj
mesh_terms: D063405:Anatomic Variation; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy; D003549:Cystic Duct / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006500:Hepatic Duct, Common / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012737:Sex Factors