title: Aberrant bile ducts, 'remnant surface bile ducts,' and peribiliary glands: descriptive anatomy, historical nomenclature, and surgical implications.
abstract: The term "aberrant bile ducts" has been used to designate three heterogeneous groups of biliary structures: (1) bile ducts degenerating or disappearing (unknown etiology, diverse locations); (2) curious biliary structures in the transverse fissure; and (3) aberrant right bile ducts draining directly into the common hepatic duct. We report our observations on these three groups. Twenty-nine fresh human livers of stillborns and adults were injected differentially with colored latex and dissected. Adult livers showed portal venous and hepatic arterial branches, and bile ducts not associated with parenchyma, subjacent to and firmly adherent with the liver capsule: elements of ramifications of normal sheaths were present on the liver's surface. These ramifications, having lost parenchyma associated with them, then sequentially lost their portal branches, bile ducts and arterial branches. This process affected the ramifications of the sheaths in the left triangular ligament, adjacent to the inferior vena cava, in the gallbladder bed and anywhere else on the liver's surface and resulted in the presence of bile ducts accompanied by portal venous and/or hepatic arterial branches and not associated with parenchyma for a period of time. This first group represented normal bile ducts that do not meet the criteria of aberration and could be appropriately designated "remnant surface bile ducts." Such changes were not found in the transverse fissures and review of the literature revealed that the curious biliary structures are the microscopic peribiliary glands. The third group met the criteria of aberration and the anatomy of a representative duct is described.
authors.affiliation: Centers for Surgical Anatomy and Technique, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Ramadan M
authors.initials: RM
authors.lastname: El Gharbawy
authors.forename: Lee J
authors.initials: LJ
authors.lastname: Skandalakis
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Heffron
authors.forename: John E
authors.initials: JE
authors.lastname: Skandalakis
mesh_terms: D000328:Adult; D017734:Bile Ducts, Extrahepatic / Q000002:abnormalities* / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D008099:Liver / Q000033:anatomy & histology / Q000098:blood supply / Q000601:surgery; D050497:Stillbirth; D009626:Terminology as Topic; D055815:Young Adult