Original Articles
Vol. 15 (2020)
https://doi.org/10.3269/1970-5492.2020.15.36
ANATOMIC VARIATIONS OF INTRAHEPATIC BILIARY SYSTEM AT MAGNETIC RESONANCE CHOLANGIO-PANCREATOGRAPHY: A SINGLE INSTITUTION EXPERIENCE AND A SYSTEMATIC REVIEW OF THE LITERATURE
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Received: October 16 2025
Published: October 16 2025
Published: October 16 2025
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The twofold purpose of this study was firstly to analyse the imaging features of various anatomical
variants of the intra-hepatic biliary tree using magnetic resonance cholangio-pancreatography
(MRCP) and to document the prevalence of each type in our population. The second aim was to
perform a systematic review in order to evaluate the prevalence of anatomic variations of the
intrahepatic biliary system in different studies and with different imaging methods. Patients who
underwent MRCP between January 2009 and December 2011 were included and analyzed. All
examinations were obtained using 1.5 Tesla MRI and 8 channel phased-array coil. In order to
compare data coming from the present study and different series published by other authors, a
comprehensive literature search using the MEDLINE and Pubmed databases was performed,
covering the period from January 1980 to December 2017. Among 534 patients, normal
morphology of the intrahepatic biliary system (Type 1) was found in 55% of cases. The second
most frequent presentation, in about 19.8% of patients, was Type 3a with right posterior duct (RPD)
emptying into the left hepatic duct. Triple confluence morphology (Type 2) was found in 10.1% of
cases; only 6.7% of patients presented with Type 3b variant with aberrant RPD draining into the
common hepatic duct. In about 8.4% of cases, more complex biliary variants were found. At the
time of this review, thirty studies employing different imaging methods were identified in the
literature search, of which fifteen used MRCP, eleven used intra-operative cholangiography, three
used CT-cholangiography and one ERCP. Taking into account all of the studies, the total number of
patients was 14,322. Type 1 presentation ranged from 40% to 80%. A correct understanding of the
biliary three anatomy through MRCP study is feasible and it may be very useful in order to plan
complex hepatobiliary surgeries and to prevent iatrogenic injuries
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ANATOMIC VARIATIONS OF INTRAHEPATIC BILIARY SYSTEM AT MAGNETIC RESONANCE CHOLANGIO-PANCREATOGRAPHY: A SINGLE INSTITUTION EXPERIENCE AND A SYSTEMATIC REVIEW OF THE LITERATURE. (2025). EuroMediterranean Biomedical Journal, 15. https://doi.org/10.3269/1970-5492.2020.15.36
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