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
