Article

Variations anatomiques des voies biliaires et conséquences chirurgicales: à propos de 19 cas

Journal Africain d?Hépato-Gastroentérologie 09/2009; 3(3):137-142. DOI: 10.1007/s12157-009-0097-6

ABSTRACT Objectifs

La connaissance de l’anatomie des voies biliaires et leurs variations sont une condition nécessaire avant toute chirurgie hépatobiliaire. Le but de ce travail est de faire le point sur les variations anatomiques des voies biliaires et de dégager leurs incidences chirurgicales.

Matériel et méthode

Étude rétrospective qui porte sur l’analyse de 70 cholangiographies peropératoire (CPO), nous avons relevé 19 cas de variations anatomiques chez 16 patients, ce qui représente 27,1 %, trois patients présentaient deux variations.

Résultats

Les variations des canaux droits ont été les plus fréquentes: 11 cas, soit 57,8 % de l’ensemble des cas. Cinq anomalies du canal cystique, soit 26,3 % et trois anomalies de l’insertion du cholédoque sur le duodénum. Aucune variation n’a intéressé les canaux biliaires gauches. Ces anomalies ont été responsables de trois accidents peropératoires au cours de la cholécystectomie, dont une péritonite biliaire et deux fistules biliaires externes.

Conclusion

Notre série confirme l’intérêt de la cholangiographie dans l’exploration des voies biliaires afin de détecter des variations pouvant compliquer l’acte opératoire.

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