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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Original article / research
Full Version
An Unusual Variation of Extra Hepatic Biliary Ductal System: Hepaticocystic Duct
Correspondence Address :
Sharmila Aristotle
SRM Medical College Hospital and Research Centre, Potheri
Kancheepuram, Tamilnadu, India - 603203
Phone: 00919790807674
E-mail: drsharmiaris@gmail.com
Aim: The aim of this study was to focus on the variations occurring in the formation of extra hepatic biliary tract. These variations can occur from the gallbladder, cystic duct, hepatic ducts, common bile duct. Most of these variations are due to aberrations in the normal embryological development.
Materials and Methods: The study was carried out in 25 foetal specimens of 7 to 9 months gestational age collected from the obstetrics and gynaecology department, Madras medical college, Chennai. Gallbladder was identified and dissection was carried out from the neck of gallbladder. Cystic duct, right hepatic duct, left hepatic duct, common hepatic duct and common bile duct were traced out. The relation of hepatic artery to the duct system was also noted.
Result: This study reports an unusual variation in a foetal specimen out of 25 foetal specimens studied by dissection. In one of the specimen the common bile duct was absent. A small common hepatic duct from the liver entered directly into the neck of gallbladder. Further drainage of bile from the gallbladder was carried out by a long cystic duct which opened into the duodenum. The right and left hepatic ducts united intra hepatically to form the common hepatic duct.
Conclusion: The variation noted here has been reported less in the literatures. knowledge of this congenital variation along with variations in cystic duct, common hepatic duct, common bile duct and the surrounding vessels is necessary to avoid iatrogenic ductal injuries and inadvertent complications during biliary surgery.
Common bile duct; Common hepatic duct; Cystic duct; Extra hepatic biliary tract
Introduction
Many congenital anomalies of extra hepatic biliary tract have been reported. Of this, congenital absence of common bile duct namely the hepticocystic duct or cholecystohepatic duct is the rarest and less frequently reported anomaly. Lamah et al described that the incidence varies between 0.58 % and 47.2 percent (1). In this, the common bile duct is absent. The right and left hepatic ducts unite together to form the common hepatic duct. This common hepatic duct drains directly into the gallbladder or the right and left hepatic ducts directly drain into the gallbladder. Further drainage of the bile from the gallbladder to the duodenum is carried out by a long cystic duct (2).
The study was carried out in 25 foetal specimens of 7 to 9 months gestational age collected from the obstetrics and gynaecology department, Madras medical college, Chennai .The dissection was carried out by opening the abdomen in midline through a vertical incision extending from the xiphisternum to umbilicus. Incision was extended laterally, from xiphisternum along the costal margin. Rectus sheath was cut in the midline. Peritoneum was opened and entered into the abdominal cavity. The stomach was reflected to the left side. Liver along with the gallbladder, duodenum, free margin of lesser omentum, epiploic foramen were identified. Dissection was started from the neck of the gallbladder and cystic duct was traced out till it meets the common hepatic duct. Further dissection was done to identify all the structures in the hepatoduodenal ligament. Common hepatic duct, right and left hepatic ducts, common bile duct were dissected. The boundaries of calot’s triangle were defined. Apart from this the relation of hepatic artery to the duct system was noted.
This variation was noted in a 37 week’s old dead born male foetus. The liver and gallbladder were seen in the normal position. The right and left hepatic ducts united to form the common hepatic duct intra hepatically. The common hepatic duct emerged from the liver was very short and it opened directly into the neck of gallbladder at the point of origin of cystic duct. Formation of common bile duct by the union of the common hepatic duct and cystic duct was absent. The cystic duct that emerged from the neck of gallbladder was long. It descended downwards and entered directly into the second part of duodenum. Apart from this, the proper hepatic artery was noted to the left of cystic duct. It divided into right and left hepatic arteries. The right hepatic artery ran a course upwards and passed posterior to the cystic duct (Table/Fig 1). All the other foetal specimens were normal in their anatomy.
The extra hepatic biliary system develops from the hepatic diverticulum of foregut along with the liver during the 4th week of foetal life. This diverticulum rapidly proliferates into the septum transversum and divides into 2 parts namely pars cystica and pars hepatica. From the pars hepatica, liver and hepatic ducts develop and from the pars cystica, gallbladder and cystic duct develop.
Losanoff et al. and Adkins et al. stated that during the development of pars cystica, at the junction of cystic and hepatic duct, the cells proliferate to form the common bile duct (3), (4). This is in a form of cylindrical mass that undergoes vacuolation to canalize and form a single continuous epithelium lined lumen. Failure of this normal pattern of development leads to various anomalies. One such anomaly is the hepaticocystic duct.
The probable hypothesis of those anomalies is failure of recanalisation of the ductal system with the persistence of the foetal communication between gallbladder and liver (5).
The other possible explanation by Walia et al is the delayed division of the hepatic antrum into cystic and hepatic diverticulum (6).
According to Losanoff JE et al. the various types of Hepaticocystic ducts are as follows (3):
• Type I: In this the common hepatic duct was absent and the right and left hepatic ducts drain separately into the gallbladder. • Type II: The right and left hepatic ducts unite upon entering the gallbladder. • Type III: Common hepatic duct enters the gallbladder. • Type III(A): Common hepatic duct enters the superior wall of gallbladder. • Type III(B): Common hepatic duct enters the neck of the gallbladder. • Type III(C): Common hepatic duct enters the posterior gallbladder wall. • Type III(D): Common hepatic duct enters the fundus of gallbladder.
In our case the common hepatic duct entered the neck of gallbladder and could be described as variation of type III (B).
Abeysuriya et al reported that a communicating artery was seen between the right hepatic artery and left hepatic artery, and an accessory hepatic artery arising from the communicating artery (7). In our specimen, the right hepatic artery was long and ran posterior to the cystic duct .Studies revealed that it is difficult to evaluate biliary anatomy because of the complicated nature of the imaging modalities, so a clear knowledge of the biliary anatomy variations is a must for the persons operating in that area (8). Presence of the Hepaticocystic duct is extremely rare.
So the study of the variational anatomy confirmed by intra operative cholangiography should be prompt for avoiding any serious complications during and after surgery. Hence this study will serve useful guidelines for the operating surgeons, gastroenterologist and radiologist working in that area.
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