title: Identification of accessory bile ducts at cholecystectomy.
abstract: The presence of accessory channels between the liver and extrahepatic bile ducts has long been recognised by anatomists and the division of such ducts may be a cause of bile leakage following cholecystectomy. However, visualisation of accessory bile ducts at operation is difficult as they are often small and sometimes less than 1 mm in diameter. Cholangiography has been used to help in the identification of accessory ducts in 50 patients included in a prospective trial. X-rays were taken after dissection of the gall bladder from its bed and extravasation of contrast was seen on five occasions (10%) suggesting leakage from divided accessory ducts. The identification of damage to accessory bile ducts in 10% of patients suggests that this may occur more frequently than previously supposed.
mesh_terms: D001652:Bile Ducts / Q000293:injuries*; D002758:Cholangiography; D002763:Cholecystectomy / Q000009:adverse effects*; D006801:Humans; D011446:Prospective Studies