Korean Journal of Gastrointestinal Endoscopy 1997;17(3): 351-361.
원저 : 담도 췌장 ; 내시경적 역행성 담관 조영술에 의한 담낭관 - 간외담관 접합부의 변형과 기형에 관한 연구 ( Original Articles : Biliary Tract & Pancreas ; Clinical Significances of Variants and Anomalies of Cystico - Hepatic Junction by Endoscopic Retrograde Cholangiography )
현진해, 이홍식, 류호상, 김창덕, 박종재 (Jin Hai Hyun, Hong Sik Lee, Ho Sang Ryu, Chang Duck Kim and Jong Jae Park)
Abstract
Background/Aims: The biliary tract often shows various morphologic abnormalities. Thus various anomalies and variations of the cystic duct have been extensively studied via cadeveric or intraoperative dissections and operative cholangiograms. The knowledge of the junction of cystic and common hepatic duct is essential for endoscopic management of biliary tract disease. But no large series identifying this critical cystico-hepatic junction(CHJ) by duodenoscopy has been reported, Methods: To know the anomaly and variant of CHJ and to evaluate its clinical significence, we retrospectively reviewed 434 cases of endoscopic retrograde cholangiography performed at Korea University Hospital from 1992 through 1993. The CHJ was categorized as lateral or medial only for unequivocal angulation in that direction, and spiral when there is overlap of the CHJ with the bile duct in the posteroanterior view. The CHJ was further modified as parallel if the course of the two ducts was closely adherent for 1 cm or more. In addition to identifying the radial takeoff, the level of the CHJ along the length of the extrahepatic biliary tree was determined. The distance from the ampulla to the junction was divided by the distance from the ampulla to the bifurcation and expressed as proximal, middle, distal, respectively. (Korean J Gastrointest Endosc 17: 351-361, 1997) (continue)
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