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Surg J (N Y) 2015; 01(01): e23-e27
DOI: 10.1055/s-0035-1567879
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Surgical Considerations of the Cystic Duct and Heister Valves

Lucas N. Pina
1   Department of Anatomy, University of Buenos Aires (UBA), Buenos Aires, Argentina
2   Department of Surgery, University of Buenos Aires (UBA), Buenos Aires, Argentina
,
Franca Samoilovich
1   Department of Anatomy, University of Buenos Aires (UBA), Buenos Aires, Argentina
,
Sebastián Urrutia
1   Department of Anatomy, University of Buenos Aires (UBA), Buenos Aires, Argentina
,
Agustín Rodríguez
1   Department of Anatomy, University of Buenos Aires (UBA), Buenos Aires, Argentina
,
Lisandro Alle
2   Department of Surgery, University of Buenos Aires (UBA), Buenos Aires, Argentina
,
Alberto R. Ferreres
2   Department of Surgery, University of Buenos Aires (UBA), Buenos Aires, Argentina
› Institutsangaben
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Publikationsverlauf

26. Juli 2015

07. Oktober 2015

Publikationsdatum:
19. November 2015 (online)

   Lizenzen und Reprints

Abstract

Objectives Heister valves are mucosal folds located on the endoluminal surface of the cystic duct (CD) and were first described by Lorenz Heister in 1732. Their presence could represent an obstacle that impedes transcystic exploration. It has been suggested that the distribution of Heister valves follows a steady rhythmic pattern in a spiral disposition; however, there is no conclusive data to support this claim. The aim of this study was to describe the main characteristics of the CD and Heister valves in adult human cadavers.

Methods A descriptive cross-sectional study was performed on 46 extrahepatic biliary tracts.

Results The CD has an average length of 25.37 mm and diameter of 4.53 mm. The most frequent level of junction was the middle union. Heister valves were present on 32 CDs; in most cases, they were distributed uniformly on the duct and presented an oblique disposition. A nonreticular pattern was the most frequent reticular pattern. The most frequent type of the nonreticular type was the B1 subtype. The most frequent type of distribution was the nonreticular type, particularly the B1 type.

Conclusions The cystic fold could hinder transcystic exploration. The cysticotomy incision should not be determined by the distribution of the fold on the CD. The morphology of the Heister valves does not show evidence of a steady systematic pattern.

Keywords

cystic duct - biliary tract - Heister valves - transcystic exploration
 

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