Explore The Length And Diameter Of The Cystic Duct And Its Relationship With The Angle Of The Common Hepatic Duct And The Formation Of Gallstones

Gallstone is a common and frequently occurring disease of the digestive system.With the increase of high calorie,high carbohydrate,low fiber diet and insufficient physical activity,the incidence of gallstone is on the rise.The prevalence of gallstone in China is about 4.6%.It has been reported that the prevalence rate in European and American countries is about 4%-26.7%,while the prevalence rate in north American indians is even as high as 29.5%-64.1%.the clinical application of laparoscopic cholecystectomy has alleviated the pain of patients caused by traditional open surgery,and also improves the cure rate of gallstone disease.However,it has brought many complications that should not be ignored,such as cholecystitis,gallbladder carcinoma,cholangitis,secondary choledocholithiasis and so on.The cause of gallstone is still being explored.Many etiological factors such as gallbladder motility disorders,chemical component have been accepted on gallstone formation,but anatomic variations of the cystic duct and the formation of gallstones are seldom discussed before.With the development of imaging,spiral CT multiplanar reconstruction is widely used in clinical practice.The purpose of this study is to reconstruct the structure of the biliary tract by CT multiplanar reconstruction,measure the length and diameter of the cystic duct and its angle with the common hepatic duct,and explore the length and diameter of the cystic duct and its relationship with the angle of the common hepatic duct and the formation of gallstones,so as to provide the prevention and treatment of gallstones.Objective:In order to analyze the length,the diameter of the cystic duct and its relationship with the angle of the common hepatic duct and the formation of gallstones,we will measure the length and diameter of the cystic duct as well as the angle of the common hepatic duct with the cystic duct by reconstructing the bile duct structure by CT multiplanar reconstruction.It will provide the prevention and treatment of gallstones.Methods:In our study,100 patients with gallstones diagnosed by abdominal CT in our hospital from October 2018 to October 2019 were selected consecutively as the gallstone group.100 patients with non-gallstones who underwent abdominal CT examination during the same period were selected as the non-gallstone group.Images were reconstructed using techniques of multiplanar reconstruction.The length and diameter of the cystic duct,the angle of the cystic duct and common hepatic duct,the diameter of the common bile duct were measured.We will calculate the ratio of the length to the diameter of the cystic duct.All the data were analyzed statistically with SPSS 22.0 software.Results:1 The length of the cystic duct in the gallstone group range from 4.8 mm to 38.2 mm(mean 16.1 mm)and that in the non-gallstone group range from 6.0 mm to 21.3 mm(mean 11.9 mm).There was a statistically significant difference in the length of the cystic duct between the gallstone group and the non-gallstone group(P<0.05).2 The diameter of the cystic duct in the gallstone group range from 3.4 mm to 6.3 mm(mean 4.8 mm)and that in the non-gallstone group range from 3.6 mm to 7.6 mm(mean 5.5 mm).There was a statistically significant difference in the diameter of the cystic duct between the gallstone group and the non-gallstone group(P<0.05).3 The angle between the cystic duct and the common hepatic duct in the gallstone group range from 10.6° to 112°(median 40.2°)and that in the non-gallstone group range from 15.1° to 61.2°(median 26.1°).There was a statistically significant difference between the angle of the cystic duct and the common hepatic duct in the gallstone group and non-gallstone group(P<0.05).4 The ratio of length to diameter of the cystic duct in the gallstone group range from 1.3 to 7.1(mean 3.2)and that in the non-gallstone group range from 1.2 to 5.1(mean 2.1).There was a statistical difference in the ratio of length to diameter of the cystic duct between the gallstone group and the non-gallstone group(P<0.05).5 The diameter of the common bile duct in the gallstone group range from 4.6 mm to 9.3 mm(mean 6.9 mm)and that in the non-gallstone group range from 3.7 mm to 8.6 mm(mean 6.5 mm).There was no significant difference in the diameter of the common bile duct between the gallstone group and the non-gallstone group(P>0.05).Conclusion:1 The longer length and/or thinner diameter of the cystic duct may be related to the formation of gallstones.2 The larger angle of the cystic duct and the common hepatic duct may be related to the formation of gallstones.