Common hepatic duct

The common hepatic duct is the first part of the biliary tract. It joins the cystic duct coming from the gallbladder to form the common bile duct.

Common hepatic duct
1: Right lobe of liver
2: Left lobe of liver
3: Quadrate lobe of liver
4: Round ligament of liver
5: Falciform ligament
6: Caudate lobe of liver
7: Inferior vena cava
8: Common bile duct
9: Hepatic artery
10: Portal vein
11: Cystic duct
12: Common hepatic duct
13: Gallbladder
Details
Identifiers
Latinductus hepaticus communis
MeSHD006500
TA98A05.8.01.061
TA23092
FMA14668
Anatomical terminology
1. Bile ducts: 2. Intrahepatic bile ducts, 3. Left and right hepatic ducts, 4. Common hepatic duct, 5. Cystic duct, 6. Common bile duct, 7. Ampulla of Vater, 8. Major duodenal papilla
9. Gallbladder.
10–11. Right and left lobes of liver.
12. Spleen.
13. Esophagus.
14. Stomach.
15. Pancreas: 16. Accessory pancreatic duct, 17. Pancreatic duct.
18. Small intestine: 19. Duodenum, 20. Jejunum
21–22. Right and left kidneys.
The front border of the liver has been lifted up (brown arrow).[1]

Structure

The common hepatic duct is the first part of the biliary tract.[2] It is formed by the union of the right hepatic duct (which drains bile from the right functional lobe of the liver) and the left hepatic duct (which drains bile from the left functional lobe of the liver).[3] It ends by uniting with the cystic duct (coming from the gallbladder) to form the bile duct.[4]

The duct is about 3 cm long.[5] The common hepatic duct is about 6 mm in diameter in adults, with some variation.[6]

Termination

The common hepatic duct typically unites with the cystic duct some 1-2cm superior to the duodenum and anterior to the right hepatic artery, with the cystic duct approaching the common hepatic duct from the right.[4]

Relations

The right branch of the hepatic artery proper usually passes posterior to the duct, but may rarely pass anterior to it instead.[5]

Histology

The inner surface is covered in a simple columnar epithelium.[3]

Variation

Accessory hepatic ducts

Around 1.7%[7] of people have additional accessory hepatic ducts that opens into the common hepatic duct.[7] Accessory hepatic ducts may also instead open into the cystic duct or gallbladder.[4]

Termination

Occasionally, the cystic duct may first run along the right side of the common bile duct for some distance before joining it, or may pass posteriorly around to the common hepatic duct to unite with it from the left side.[4]

Rarely, the common hepatic duct and gallbladder joing directly (with the cystic duct being absent),[7][4] leading to illness.[7]

Function

The hepatic duct is part of the biliary tract that transports secretions from the liver into the intestines.

Clinical significance

Cholecystectomy

The common hepatic ducts carries a higher volume of bile in people who have had their gallbladder removed.

The common hepatic duct is an important anatomic landmark during surgeries such as cholecystectomy. It forms one edge of Calot's triangle, along with the cystic duct and the cystic artery. All constituents of this triangle must be identified to avoid cutting or clipping the wrong structure.

Cholestasis

A diameter of more than 8 mm is regarded as abnormal dilatation, and is a sign of cholestasis.[8]

Mirizzi's syndrome

Mirizzi's syndrome occurs when the common hepatic duct is blocked by gallstones.[9]

Additional images
  • Biliary tract
    Biliary tract
  • Common hepatic duct
    Common hepatic duct
  • Common hepatic duct
    Common hepatic duct
  • The portal vein and its tributaries
    The portal vein and its tributaries
  • The gall-bladder and bile ducts laid open
    The gall-bladder and bile ducts laid open

References
  1. Standring S, Borley NR, eds. (2008). Gray's anatomy : the anatomical basis of clinical practice. Brown JL, Moore LA (40th ed.). London: Churchill Livingstone. pp. 1163, 1177, 1185–6. ISBN 978-0-8089-2371-8.
  2. Manohar, Rohan; Lagasse, Eric (2014-01-01), Lanza, Robert; Langer, Robert; Vacanti, Joseph (eds.), "Chapter 45 - Liver Stem Cells", Principles of Tissue Engineering (Fourth Edition), Boston: Academic Press, pp. 935–950, doi:10.1016/b978-0-12-398358-9.00045-8, ISBN 978-0-12-398358-9, retrieved 2021-01-26
  3. Bergman, Simon; Geisinger, Kim R. (2008-01-01), Bibbo, Marluce; Wilbur, David (eds.), "CHAPTER 14 - Alimentary Tract (Esophagus, Stomach, Small Intestine, Colon, Rectum, Anus, Biliary Tract)", Comprehensive Cytopathology (Third Edition), Edinburgh: W.B. Saunders, pp. 373–408, ISBN 978-1-4160-4208-2, retrieved 2021-01-26
  4. Sinnatamby, Chummy S. (2011). Last's Anatomy (12th ed.). p. 265. ISBN 978-0-7295-3752-0.
  5. Sinnatamby, Chummy S. (2011). Last's Anatomy (12th ed.). p. 265. ISBN 978-0-7295-3752-0.
  6. Gray's Anatomy, 39th ed, p. 1228
  7. Portmann, Bernard C.; Roberts, Eve A. (2012-01-01), Burt, Alastair D.; Portmann, Bernard C.; Ferrell, Linda D. (eds.), "3 - Developmental abnormalities and liver disease in childhood", MacSween's Pathology of the Liver (Sixth Edition), Edinburgh: Churchill Livingstone, pp. 101–156, ISBN 978-0-7020-3398-8, retrieved 2021-01-26
  8. Hoeffel, Christine; Azizi, Louisa; Lewin, Maité; Laurent, Valérie; Aubé, Christophe; Arrivé, Lionel; Tubiana, Jean-Michel (2006). "Normal and Pathologic Features of the Postoperative Biliary Tract at 3D MR Cholangiopancreatography and MR Imaging". RadioGraphics. 26 (6): 1603–1620. doi:10.1148/rg.266055730. ISSN 0271-5333. PMID 17102039.
  9. Katz, Seth S. (2017-01-01), Jarnagin, William R. (ed.), "Chapter 18 - Computed tomography of the liver, biliary tract, and pancreas", Blumgart's Surgery of the Liver, Biliary Tract and Pancreas, 2-Volume Set (Sixth Edition), Philadelphia: Elsevier, pp. 316–357.e6, ISBN 978-0-323-34062-5, retrieved 2021-01-26
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