Cawich SO, Sinanan A, Deshpande RR, Gardner MT, Pearce NW, Naraynsingh V. Anatomic variations of the intra-hepatic biliary tree in the Caribbean: A systematic review. World J Gastrointest Endosc 2021; 13(6): 170-183 [PMID: 34163564 DOI: 10.4253/wjge.v13.i6.170]
Corresponding Author of This Article
Shamir O Cawich, FACS, Professor, Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine Campus, St Augustine 000000, Trinidad and Tobago. socawich@hotmail.com
Research Domain of This Article
Anatomy & Morphology
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Jun 16, 2021; 13(6): 170-183 Published online Jun 16, 2021. doi: 10.4253/wjge.v13.i6.170
Anatomic variations of the intra-hepatic biliary tree in the Caribbean: A systematic review
Shamir O Cawich, Alexander Sinanan, Rahul R Deshpande, Michael T Gardner, Neil W Pearce, Vijay Naraynsingh
Shamir O Cawich, Alexander Sinanan, Vijay Naraynsingh, Department of Clinical Surgical Sciences, University of the West Indies, St Augustine 000000, Trinidad and Tobago
Rahul R Deshpande, Department of Surgery, Manchester Royal Infirmary, Manchester M13 9WL, United Kingdom
Michael T Gardner, Department of Anatomy, University of the West Indies, Kingston KIN7, Jamaica
Neil W Pearce, Department of Surgery, Southampton University NHS Trust, Southampton SO16DP, Southampton, United Kingdom
Author contributions: Cawich SO and Sinanan A designed and coordinated the study; Gardner MT, Pearce NW and Deshpande RR performed experiments, acquired and analyzed data; Cawich SO, Gardner MT, Sinanan A, Pearce NW and Deshpande RR interpreted the data; Cawich SO and Gardner MT wrote the manuscript; all authors approved the final version of the article.
Conflict-of-interest statement: There are no conflicts of interest to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shamir O Cawich, FACS, Professor, Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine Campus, St Augustine 000000, Trinidad and Tobago. socawich@hotmail.com
Received: January 25, 2021 Peer-review started: January 25, 2021 First decision: March 1, 2021 Revised: March 15, 2021 Accepted: May 20, 2021 Article in press: May 20, 2021 Published online: June 16, 2021
ARTICLE HIGHLIGHTS
Research background
There have been many documented variations of the anatomy of the intra-hepatic bile ducts, but to the best of our knowledge there has been no report on bile duct variations in Caribbean populations. This information is important to optimize healthcare services for providers with interests in treating liver disorders.
Research motivation
This research sought to determine the bile duct variations in a Caribbean population. This will help to optimize hepatobiliary services in the region. We have also defined the global prevalence which will serve as a basis for further research in this field.
Research objectives
We sought to document the variations in bile duct anatomy using magnetic resonance cholangiography (MRC) at a major hepatobiliary referral centre in the Eastern Caribbean.
Research methods
We evaluated MRC images from 152 consecutive patients over a two-year period and described biliary anatomy according to the Huang’s classification. A systematic review of all available published studies was performed. Raw data were extracted and used to calculate the global prevalence of each variant for comparisons to the variants in our population.
Research results
Classic anatomy was present in 71.7% of persons and 28.3% of persons had variant anatomy. The most common variant was Huang type 2 (19%), followed by type 3 (4.6%), type 4 (3.95%) and type 5 (0). One variant did not fit the Huang classification system. This Caribbean population had a significantly greater number of type 2 variants (19.1% vs 11.5%; P = 0.0069), but a significantly lower incidence of type 3 variants (4.61% vs 11.5%; P = 0.0047).
Research conclusions
There are significant differences in biliary anatomy in this Caribbean population compared to global statistics. The new method this study proposes is to use the definition of global prevalence to compare anatomic variations.
Research perspectives
Future research can focus on variations of extra-hepatic biliary anomalies using the global prevalence template.
