Comparison of cystic duct and bile duct anatomy in patients with acute cholecystitis and healthy individuals

ABSTRACT Objective: The aim of this study was to evaluate the impact of anatomical variations of the biliary system, particularly the cystic duct, on the development of acute cholecystitis. The role of cystic duct morphology (length, diameter, configuration, junction site, and angle) in the pathogenesis of acute cholecystitis has not been sufficiently investigated in the literature, and their correlation with clinical and laboratory parameters remains unclear. Methods: This retrospective descriptive study was conducted at Süleyman Demirel University Faculty of Medicine Hospital, including patients who underwent MRCP between 2015 and 2024. Eighty-two patients diagnosed with acute cholecystitis and 30 control subjects were evaluated. MRCP images were reviewed by a single radiologist in a blinded manner. Morphological features of the cystic duct were systematically recorded and analyzed in relation to clinical and laboratory findings. Results: No significant difference was observed between the groups in terms of cystic duct length and diameter. However, tortuosity was significantly more frequent in the acute cholecystitis group (p=0.004). Posterior and medial junctions of the cystic duct, as well as a narrow cystic duct–common bile duct angle (≤90°), were identified as independent risk factors for acute cholecystitis. Conclusion: MRCP-based evaluation of cystic duct variations provides valuable insights into the development of acute cholecystitis. Tortuosity, posterior–medial junction patterns, and narrow junction angles represent predictive anatomical indicators that may guide early diagnosis and surgical planning.