Accessory bile duct

Accessory bile duct

An accessory bile duct is a conduit that transports bile and is considered to be supernumerary or auxiliary to the biliary tree.^[1]

It may be described by its location relative to the gallbladder as supravescicular^[2][3] (superior to the gallbladder body) or subvesicular^[4][5] (inferior to the gallbladder body).

Duct of Luschka

In the surgical literature, the term duct of Luschka is used to refer to an accessory bile duct that does not communicate with the gallbladder lumen. The term is ambiguous otherwise, as it may refer to supravescicular^[2][3] or subvescicular ducts.^[4][5] Supravesicular ducts are typically in the gallbladder bed.

Accessory cystic ducts are excluded from the definition of duct of Luschka; however, they are accessory bile ducts.

Clinical significance

Although they may not drain any liver parenchyma, they can be a source of a bile leak or biliary peritonitis after cholecystectomy in both adults and children. If an accessory bile duct goes unrecognized at the time of the gallbladder removal, 5-7 days post-operative the patient will develop bile peritonitis,^{[citation needed]} an easily treatable complication with a morbidity rate of 44% if left untreated.

Often diagnosed by HIDA scan, a bile leak from an accessory bile duct post-op can be treated with a temporary biliary stent^{[citation needed]} to redirect the bile from the liver into the intestine and allow the accessory duct to spontaneously seal themselves.

Eponym

The duct of Luschka is named after German anatomist Hubert von Luschka (1820-1875)^[6]

References

1. ^ accessory at eMedicine Dictionary
2. ^ ^{a b} Sharif K, de Ville de Goyet J (November 2003). "Bile duct of Luschka leading to bile leak after cholecystectomy--revisiting the biliary anatomy". J. Pediatr. Surg. 38 (11): E21–3. doi:10.1016/j.jpedsurg.2003.08.008. PMID 14614740. http://linkinghub.elsevier.com/retrieve/pii/S0022346803005980. 
3. ^ ^{a b} McQuillan T, Manolas SG, Hayman JA, Kune GA (July 1989). "Surgical significance of the bile duct of Luschka". Br J Surg 76 (7): 696–8. doi:10.1002/bjs.1800760715. PMID 2765803. 
4. ^ ^{a b} Ko K, Kamiya J, Nagino M, et al. (July 2006). "A study of the subvesical bile duct (duct of Luschka) in resected liver specimens". World J Surg 30 (7): 1316–20. doi:10.1007/s00268-005-0469-z. PMID 16830216. 
5. ^ ^{a b} Spanos CP, Syrakos T (September 2006). "Bile leaks from the duct of Luschka (subvesical duct): a review". Langenbecks Arch Surg 391 (5): 441–7. doi:10.1007/s00423-006-0078-9. PMID 16927110. 
6. ^ Luschka's ducts at Who Named It?