Effect of biliopancreatic tree anatomy on development of acute gallstone pancreatitis

Abstract Background Acute pancreatitis (AP) is a complex disorder with gallstones being the most common underlying cause. Anatomical variations of gallbladder, cystic duct (CD), common bile duct and main pancreatic duct and their courses and interactions with each other have been studied and shown t...

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Main Authors: Ahmet Sukru Alparslan, Serkan Ocal, Osman Cagin Buldukoglu, Galip Egemen Atar, Lutfullah Zahit Koc, Merve Eren Durmus, Serdar Akca, Ferda Akbay Harmandar, Ayhan Hilmi Cekin
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Gastroenterology
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Online Access:https://doi.org/10.1186/s12876-025-03866-3
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author Ahmet Sukru Alparslan
Serkan Ocal
Osman Cagin Buldukoglu
Galip Egemen Atar
Lutfullah Zahit Koc
Merve Eren Durmus
Serdar Akca
Ferda Akbay Harmandar
Ayhan Hilmi Cekin
author_facet Ahmet Sukru Alparslan
Serkan Ocal
Osman Cagin Buldukoglu
Galip Egemen Atar
Lutfullah Zahit Koc
Merve Eren Durmus
Serdar Akca
Ferda Akbay Harmandar
Ayhan Hilmi Cekin
author_sort Ahmet Sukru Alparslan
collection DOAJ
description Abstract Background Acute pancreatitis (AP) is a complex disorder with gallstones being the most common underlying cause. Anatomical variations of gallbladder, cystic duct (CD), common bile duct and main pancreatic duct and their courses and interactions with each other have been studied and shown to be related to development of AP in various studies. With this study, we aimed to investigate the relationship between biliopancreatic tree anatomy and acute gallstone pancreatitis. Materials and methods 157 gallstone related AP patients and 75 control group patients were enrolled in the study. The level at which cystic duct opened to common bile duct (as in proximal-mid-distal 1/3) and type of cystic duct course and opening (parallel to CBD, perpendicular to CBD, straight anatomy, tortuous anatomy) were evaluated from MRCP scans. Additionally, diameters of main pancreatic duct, common bile duct and angles between main pancreatic duct-common bile duct and cystic duct-common bile duct were calculated. Results All investigated parameters except CD opening angle were statistically significantly different between two groups. MPD opening angle was more acute in the control group. Parallel and tortuous CD was more common in the patient group. Patients with acute gallstone pancreatitis were more likely to have CD opening to the second and third parts of CBD. Conclusion Anatomy of the biliopancreatic tree and its variations are related to acute gallstone pancreatitis. Several proposed mechanism are thought to play role in this phenomenon but future prospective studies are required to reveal more on the topic.
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spelling doaj-art-fed6005393e34aefa4e37c49f07e43fc2025-08-20T02:27:54ZengBMCBMC Gastroenterology1471-230X2025-04-0125111010.1186/s12876-025-03866-3Effect of biliopancreatic tree anatomy on development of acute gallstone pancreatitisAhmet Sukru Alparslan0Serkan Ocal1Osman Cagin Buldukoglu2Galip Egemen Atar3Lutfullah Zahit Koc4Merve Eren Durmus5Serdar Akca6Ferda Akbay Harmandar7Ayhan Hilmi Cekin8Department of Radiology, Antalya Training and Research Hospital, University of Health SciencesDepartment of Gastroenterology, Antalya Training and Research Hospital, University of Health SciencesDepartment of Gastroenterology, Antalya Training and Research Hospital, University of Health SciencesDepartment of Gastroenterology, Antalya Training and Research Hospital, University of Health SciencesDepartment of Internal Medicine, Antalya Training and Research Hospital, University of Health SciencesDepartment of Gastroenterology, Antalya Training and Research Hospital, University of Health SciencesDepartment of Gastroenterology, Antalya Training and Research Hospital, University of Health SciencesDepartment of Gastroenterology, Antalya Training and Research Hospital, University of Health SciencesDepartment of Gastroenterology, Antalya Training and Research Hospital, University of Health SciencesAbstract Background Acute pancreatitis (AP) is a complex disorder with gallstones being the most common underlying cause. Anatomical variations of gallbladder, cystic duct (CD), common bile duct and main pancreatic duct and their courses and interactions with each other have been studied and shown to be related to development of AP in various studies. With this study, we aimed to investigate the relationship between biliopancreatic tree anatomy and acute gallstone pancreatitis. Materials and methods 157 gallstone related AP patients and 75 control group patients were enrolled in the study. The level at which cystic duct opened to common bile duct (as in proximal-mid-distal 1/3) and type of cystic duct course and opening (parallel to CBD, perpendicular to CBD, straight anatomy, tortuous anatomy) were evaluated from MRCP scans. Additionally, diameters of main pancreatic duct, common bile duct and angles between main pancreatic duct-common bile duct and cystic duct-common bile duct were calculated. Results All investigated parameters except CD opening angle were statistically significantly different between two groups. MPD opening angle was more acute in the control group. Parallel and tortuous CD was more common in the patient group. Patients with acute gallstone pancreatitis were more likely to have CD opening to the second and third parts of CBD. Conclusion Anatomy of the biliopancreatic tree and its variations are related to acute gallstone pancreatitis. Several proposed mechanism are thought to play role in this phenomenon but future prospective studies are required to reveal more on the topic.https://doi.org/10.1186/s12876-025-03866-3Biliopancreatic anatomyGallstoneAcute pancreatitisBiliary ductPancreatic duct
spellingShingle Ahmet Sukru Alparslan
Serkan Ocal
Osman Cagin Buldukoglu
Galip Egemen Atar
Lutfullah Zahit Koc
Merve Eren Durmus
Serdar Akca
Ferda Akbay Harmandar
Ayhan Hilmi Cekin
Effect of biliopancreatic tree anatomy on development of acute gallstone pancreatitis
BMC Gastroenterology
Biliopancreatic anatomy
Gallstone
Acute pancreatitis
Biliary duct
Pancreatic duct
title Effect of biliopancreatic tree anatomy on development of acute gallstone pancreatitis
title_full Effect of biliopancreatic tree anatomy on development of acute gallstone pancreatitis
title_fullStr Effect of biliopancreatic tree anatomy on development of acute gallstone pancreatitis
title_full_unstemmed Effect of biliopancreatic tree anatomy on development of acute gallstone pancreatitis
title_short Effect of biliopancreatic tree anatomy on development of acute gallstone pancreatitis
title_sort effect of biliopancreatic tree anatomy on development of acute gallstone pancreatitis
topic Biliopancreatic anatomy
Gallstone
Acute pancreatitis
Biliary duct
Pancreatic duct
url https://doi.org/10.1186/s12876-025-03866-3
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