Hepatic duct, common

Outside the liver the common hepatic duct is joined by the cystic duct of the gallbladder and becomes the common bile duct (CBD). The extrahepatic and intrahepatic ducts are supplied with blood by a fine network of tiny arterial branches that originate from the hepatic and gastroduodenal arteries. As it has no other blood supply, the biliary tree is particularly susceptible to ischaemic injury, such as hepatic artery thrombosis or injury to the biliary plexus during laparoscopic surgery. This can result in extrahepatic and complex hilar and perihilar ischaemic strictures of the biliary tree. 

Quinn, R.J., Meredith, Ch., Slade, L. The effect of the Valsalva maneuver on the diameter of the common hepatic duct in extrahepatic biliary obstruction. J. Ultrasound Med. 1992 11 143-145... 

During cholecystectomy, choledocholithiasis was found in 12-24%o of cases. A stone-free gall bladder does not exclude cholangiolithiasis. About 80% of the bile-duct stones are found in the choledochus, 15% in the common hepatic duct and 5% in the intrahepatic bile ducts. In obstructive cholangitis, the recognition and removal... 

Fig. 32.15 Staghorn calculus in the common bile duct and the two branches of the common hepatic duct (so-called Mercedes-star type) in primary sclerosing cholangitis...

In 27 patients who received intrahepatic floxuridine, total dose 20-41 mg/kg extrahepatic biliary sclerosis was discovered by CT scan and ultrasound, followed by endoscopic retrograde cholangiopancreatography and/or percutaneous cholangiography in three cases (4). Radiological findings included complete obstruction of the common hepatic duct in one case, common hepatic duct stenosis in two cases, common bile duct obstruction in one case, and intrahepatic bile duct dilatation without identifiable obstruction in one case... 

Bile produced by hepatocytes is secreted into the bile canaliculi between adjacent hepatic cells. The wall of the canaliculus is formed by the plasma membrane of the hepatocytes, which are held together by tight junctions. Canaliculi arise near central veins and extend to the periphery of the lobules. The direction of bile flow in the canaliculi is centrifugal, whereas that of the blood flow is centripetal. Canaliculi coalesce to form ducts, which are lined by epithelium, and the ducts coalesce to form the right and left hepatic ducts. Outside the liver these ducts form the common hepatic duct. 

Fig. 3.9. Coronal reformatted CT image (left) shows enhancing mass (arrow) in common hepatic duct obstructing the duct and causing jaundice. Findings are most consistent with cholangiocarcinoma. ERCP image (right) confirms stricture which was proven to he a cholangiocarcinoma at surgery...

Fig. 22.1a,b. Aberrant bile duct. Both coronal oblique MIP 3D heavily T2-weighted (a) andmangafodipir-trisodium-enhanced Tl-weighted (b) MR cholangiograms show the aberrant drainage of the right posterior duct into the common hepatic duct in this patient with a history of recurrent choledocholithiasis after cholecystectomy, a residual cystic duct is also appreciable... 

Fig. 22.6a-c. Biliary lithiasis in a patient with hepaticojejunostomy. Coronal thin MIP 3D heavily T2-weighted MR chol-angiograms (a,b) show the presence of multiple stones into both the right hepatic duct and the pre-anastomotic common hepatic duct. Coronal thick MIP 3D heavily T2-weighted MR cholangiogram (c) better shows the dilation of the intrahepatic biliary system, the right and left hepatic ducts and the common hepatic duct... 

C Aberrant drainage of right segmental ducts into the common hepatic duct... 

Fig. 4.2. 36. Coronal thick-slab T2-weighted SSFSE MRCP image shows an aberrant right hepatic duct (arrow) draining directly into the common hepatic duct (arrowhead)...

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