Incidence and clinical significance of biliary and pancreatic duct variations on magnetic resonance cholangiopancreatography.

PURPOSE: This study aimed to determine the incidence of anatomical variations of the biliary and pancreatic ducts using Magnetic Resonance Cholangiopancreatography (MRCP) and to evaluate their associations with inflammatory and malignant conditions.

METHODS

In this retrospective study, MRCP examinations performed between April 2022 and December 2023 were reviewed through the Picture Archiving and Communication System (PACS) regardless of clinical data. Biliary and pancreatic duct variations; the presence of gallbladder or biliary sludge/stones; findings of acute cholecystitis or pancreatitis; and masses or cysts in the pancreas and biliary tract were assessed. Categorical variables were analyzed using the Chi-square or Fisher's exact test, with p < 0.05 considered statistically significant.

RESULTS

Of the 973 patients, 560 (58%) were female and 413 (42%) were male, with a mean age of 60.47 ± 17.33 years. Biliary tract variations were identified in 522 patients (53.6%), most frequently type II (27.78%), type D (26.25%), and type IIIa (15.52%). Pancreatic duct variations were found in 26 patients (2.67%), predominantly pancreas divisum (53.85%), pancreatobiliary junction anomaly (34.62%), and ansa pancreatica (11.54%). Gallstones were present in 474 patients (48.7%), masses in 93 (9.55%), acute cholecystitis in 177 (17.9%), and acute pancreatitis in 78 (8%). Biliary tract variation was significantly associated with gallstones (p < 0.05), while no significant associations were observed for other conditions or for pancreatic duct variations (p > 0.05).

CONCLUSION

MRCP effectively identifies biliary and pancreatic ductal variations, which have important clinical implications. Accurate recognition of these variations may help prevent complications during diagnostic and surgical procedures and improve treatment planning.