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Common hepatic duct

Confluence

Formed at the porta hepatis by union of the right and left hepatic ducts, it descends 3-4 cm in the free edge of the lesser omentum, to the right of the hepatic artery proper and in front of the portal vein, until the cystic duct joins it. It forms the medial border of the cystohepatic (Calot's) triangle.

Traced from the start

  1. Right hepatic ductLeft hepatic duct
  2. Common hepatic duct

Detail

Length
About 3-4 cm
Relations
Right of the hepatic artery proper, anterior to the portal vein, in the free edge of the lesser omentum
Calot's triangle
Medial border (cystic duct lateral, inferior surface of liver above)

When it goes wrong

Stone impacted in the cystic duct or Hartmann's pouch compressing the adjacent common hepatic duct (Mirizzi syndrome)

Obstructive jaundice and cholangitis with no stone in the bile duct itself; chronic erosion can create a cholecystocholedochal fistula

Common hepatic duct misidentified as the cystic duct at laparoscopic cholecystectomy (no 'critical view of safety')

Major bile duct transection: bile leak and biloma in the first days, or a stricture with obstructive jaundice weeks later

Practise this structure

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