Common bile duct

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Common bile duct
Diagram of the biliary tree showing the common bile duct
Details
Part ofBiliary tract
Identifiers
Latinductus choledochus,[1]
ductus biliaris[1]
Acronym(s)CBD[2]
MeSHD003135
TA98A05.8.02.013
TA23103
FMA14667
Anatomical terminology
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).[3]

The bile duct

hepatopancreatic ampulla. It possesses its own sphincter
to enable regulation of bile flow.

Anatomy

The bile duct is some 6–8 cm long, and normally up to 8 mm in diameter.[4]

Its proximal supraduodenal part is situated within the free edge of the lesser omentum. Its middle retroduodenal part is oriented inferiorly and right-ward, and is situated posterior to the first part of the duodenum, and anterior to the inferior vena cava. Its distal paraduodenal part is oriented still more right-ward, is accommodated by a groove upon (sometimes a channel within) the posterior aspect of the head of the pancreas, and is situated anterior to the right renal vein.[4]

The bile duct terminates by uniting with the

hepatopancreatic ampulla.[4]

The distal extremity of the bile duct invariably features its own sphincteric muscle (the pancreatic duct and the hepatopancreatic ampulla usually possess sphincters of their own to allow the flow of pancreatic juice to be regulated independently, however, these two can be absent).[4]

Clinical significance

Several problems can arise within the common bile duct, usually related to its obstruction. Opinions vary slightly on the maximum calibre of a normal CBD, but 6mm is one accepted upper limit of normal [5] with a further 1mm diameter allowed for each decade over 60 years.

It normally gets slightly dilated after cholecystectomy, with upper limit (95% prediction interval) being about 10 mm after a few months.[6]

On

hepatic artery
.

  • Borderline of a dilated perihilar bile duct, measuring 8 mm.
    Borderline of a dilated perihilar bile duct, measuring 8 mm.
  • Dilatation of CBD due to Ampullary tumor.
    Dilatation of CBD due to Ampullary tumor.

Obstruction

Tumours in the head of the pancreas may come to obstruct the distal bile duct.[4]

If obstructed by a

choledocholithiasis can result.[7] In this obstructed state, the duct is especially vulnerable to an infection called ascending cholangitis. One form of treatment is a cholecystenterostomy. Rare deformities of the common bile duct are cystic dilations (4 cm), choledochoceles (cystic dilation of the ampula of Vater (3–8 cm)), and biliary atresia
.

History

Obstruction of the common bile duct and related jaundice has been documented since at least since the time of Erasistratus.[8]

Additional images

  • The gall-bladder and bile ducts laid open.
    The gall-bladder and bile ducts laid open.

See also

  • Choledochoduodenostomy - a surgical procedure to create a connection between the common bile duct (CBD) and an alternative portion of the duodenum.

References

  1. ^ a b c "Anatonomina". terminologia-anatomica.org. Retrieved 2023-07-07.
  2. ISBN 9781609133603
    .
  3. ISBN 978-0-8089-2371-8
    .
  4. ^
    ISBN 978-0-7295-3752-0
    .
  5. ^ Oh, Lawrence. "Common bile duct | Radiology Reference Article | Radiopaedia.org". Radiopaedia. Retrieved 2021-08-30.
  6. PMID 7676981
    .
  7. ISBN 978-0781719377
    .
  8. ISBN 9400941730
    .

External links
Retrieved from "https://en.wikipedia.org/w/index.php?title=Common_bile_duct&oldid=1187940827"