Bile duct of luschka leading to bile leak after cholecystectomy—revisiting the biliary anatomy

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Abstract

Bile ducts of Luschka (also called supravesicular ducts) are small bile ducts in the gallbladder bed. Although they do not drain any liver parenchyma, they can be a source of bile leak or biliary peritonitis after cholecystectomy in both adults and children, as shown in this case report. As a reminder, variations of biliary anatomy in the gallbladder bed and cholecysto-hepatic triangle of Calot, are reviewed.

Section snippets

Case report

A 12-year-old boy with a primary diagnosis of hereditary spherocytosis and jaundice was referred after repeated episodes of pain in the right upper quadrant. In the medical history, he had undergone a laparotomy for splenectomy 5 years before and a thoracotomy for removal of a thrombus from the superior vena cava 3 years before. At ultrasonographic examination, stones in the gallbladder and the dilated common bile duct were seen. At operation, a hugely distended gallbladder was found, and the

Discussion

Luschka described aberrant biliary ductules in the gallbladder fossa in 1863.1 These often are small, less than 1 mm diameter, bile ducts running along the gallbladder fossa between the gallbladder and the liver parenchyma. They also have been described as “subvesicular” or “supravesicular ducts” by other anatomists (Champetier et al2 and Couinaud3, respectively). Interestingly, they are not accompanied by artery or vein as are normal bile ducts entering the liver parenchyma and also do not

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