Ductal Drainage

DUCTAL DRAINAGE

Ductal drainage of the liver is via the bile duct system, which originates between the cells as bile canaliculi, joining to form bile ductule.

Segmental drainage to form the
right,
left,
midlle, and
common hepatic ducts, and finally
common bile duct

The ampulla represents the confluens of the bile and pancreatic ducts to drain into the duodenum.

 

Bile Ducts

Bile ducts accompany the hepatic artery and the portal vein throughout the liver. Bile, which is created in the hepatocytes, is secreted and collected after passing through the bile capillaries by the bile ducts, which join to form two large ducts that unite to form the hepatic duct. The bile is either carried to the gallbladder by the cystic duct or transported directly into the duodenum by the common bile duct.

 

anatomy of the bile duct the bile duct is anatomically characterized by its tubular nature its connections to the gallbladder and duodenum and pancreatic duct and its relationship to the portal vein and hepatic artery.

module28_24560%20I.jpg

Branches of the bile duct
 The biliary branches follow the pattern as described for the hepatic artery and portal vein. Each lobe of the liver is supplied by a main branch-the right or the left, and then they each branch into the appropriate subsegments.  (Image courtesy of Ashley Davidoff M.D.)

 

module28_24560%20I%209.jpg

Branches of the bile duct
 This color overlay shows the confluence of the right, left, and middle hepatic bile ducts. Usually the middle duct joins the left duct and as a common left trunk, they join the right. This case is a variant of the normal. (Image courtesy of Ashley Davidoff M.D.)

The liver cells are accompanied by bile canalliculi (small bile channels) which are situated between neighboring liver cells. These become confluent at the periphery of the liver lobule and form the bile ductule member of the portal triad.

 

module28_24560%20I%208.jpg

Bile ductules to bile ducts 
 The color overlay shows the connection between the bile ductule at the periphery of the sinusoid and the branches of the bile ducts. (Image courtesy of Ashley Davidoff M.D.)

 

module28_22391%20R%20W3.jpg

Bile duct and pancreatic duct
 The right and left ducts join to form the common bile duct, which usually joins with the pancreatic duct before entering the duodenum. (Image courtesy of Ashley Davidoff M.D.)

This is an MRCP – magnetic resonance cholangiopancreatogram, showing a coronal view of the distal common bile duct becoming confluent with the pancreatic duct at the duodenum.

module28_17088.jpg

Bile duct stone
 A large filling defect, representing a bile duct stone is noted in the distal common bile duct. Review the last image on the previous page to refresh the anatomy.  (Image courtesy of Ashley Davidoff M.D.)

 

Web Links for the Bile Duct

Bile Duct RSNA 2005

A Review of Biliary Ductal Anatomy and an Overview of Percutaneous Biliary Procedures

 

Metabolic Warehouse