Anatomical Variations of Cystic Duct Encountered during Open Cholecystectomy

Objective: To determine the frequency of various anatomical variations of the cystic duct observed during open cholecystectomy in our set up. Methodology: This study was conducted at department of surgery, Khyber Medical University (KMU), Institute of Medical Sciences (KIMS), Kohat, and a private surgical centre at Kohat, Pakistan. Adult patients of both genders, who underwent open cholecystectomy from January 2009 to February 2011, were included in the study. A structured proforma was designed including patients’ demographics, history, clinical examination, relevant investigations, peroperative findings and post operative complications. Data was analyzed statistically by using SPSS version 14. Results: Out of three hundred operated patients, 248 (82.7%) were females and 52 (17.3%) were males. Mean age was 46.13+7.77 years. Short cyst duct (n=7; 2.3%), long cystic duct (n=5; 1.7%), cystic duct arising from right hepatic duct (n=5; 1.7%) and double cystic duct (n=4; 1.3%) were the most frequent anatomical variants. The frequency of various anatomical variations of cystic duct was found to be 8.33 % (n=25/300). The cystic duct branched off from the common hepatic duct in 95% of the patients. Wound infection was the most common complication and was found in 9 (03%) cases. No mortality was observed in the series. Mean hospital stay was 3.6+1.5 days. Conclusion: Anatomic variations of cystic duct are not uncommon in our set up. Short cyst duct, long cystic duct, cystic duct arising from right hepatic duct and double cystic duct are the common anatomic variants in our patients.