Background: The objective of this study is to assess the frequency of anatomic variations of the biliary system in the
The Palestinian population in patients undergoing MRCPs.
Methods: For a period of 3 years, from March 2016 to January 2019, a total of 401 MRCPS were performed in
different Palestinian Medical Centers for different indications. 346 Images were included in the study. Images were
evaluated independently by two expert radiologists for the presence of variations in the anatomy of the gallbladder, cystic
duct, common bile duct, pancreatic duct, pancreas, and intrahepatic ducts.
Results: About 78% of the images had normal anatomy of Intra-hepatic ducts. Right posterior duct joining the right
anterior duct by its lateral side was observed in 12.6% of images and triple confluence in 8.5% of images. About 12%
of the gallbladder, images have anatomical variation; multi-septate in 4.1% of images and ectopic in 3.7% images. For
the cystic duct, it was abnormally low in 9.6% of images and high in 5.3% of images. The cystic duct was found
parallel in 2.3% of images. Variations of the pancreatic duct were evident in 3.9% of the images.
Conclusions: Anatomical variations of the pancreaticobiliary system are common and they are worth the attention to
prevent major complications during hepatobiliary surgeries.