SynthesisSurgical and radiologic anatomy : SRA2025
A cautionary tale of anatomical variations of the extrahepatic biliary system and their implications for surgical procedures: a systematic literature review.
Synthesis in Surgical and radiologic anatomy : SRA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Cystic duct anatomical variations and the risk of choledocholithiasis: a systematic review and meta-analysis.Annals of gastroenterology · 2026Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe hepatobiliary system has the most associated anatomical variations in the body and they are a direct reflection of the complexity of its embryological development. The anatomical pattern commonly described as 'normal' occurs only in 57-72% of the population. The objective of the study is to review the English Language published literature on the prevalence of the anatomical extra-hepatic biliary system variations and their potential implications for surgical and endoscopic procedures. This will assist both practicing and trainee surgeons in preventing biliary tract injuries while operating in this area. METHODOLOGY: A comprehensive literature search was conducted using the PICO framework across SCOPUS, PubMed, MEDLINE, and Cochrane databases. Study characteristics and relevant data were collated. The prevalence of the most clinically important anatomical variations is presented.
resultsSeventy studies, encompassing 17,207 subjects, were included: 27 studies (9,738 subjects) on cystic duct variations, 17 studies (2,633 subjects) on gallbladder variations, and 26 studies (4,836 subjects) on cystic artery variations. Notable findings include low insertion (11.2%), medial insertion (9.8%), and parallel course (7.4%) of the cystic duct, Hartmann's pouch in 12.2% of gallbladders, and the cystic artery originating from the right hepatic artery in 83.6% or other sources in 16.4%. Moynihan's hump of the right hepatic artery was found in 1.8%.
conclusionThese variations are frequent and surgically relevant. Understanding them is critical to avoiding complications. Employing the critical view of safety in laparoscopic cholecystectomy ensures proper visualization of anatomical structures, reducing the risk of injury.
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Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.