[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Abdomen](https://durgical.com/en/anatomy/region/abdomen/) › Common hepatic duct [Digestive system](https://durgical.com/en/anatomy/system/digestive-system/) · [Abdomen](https://durgical.com/en/anatomy/region/abdomen/) # Common hepatic duct The common hepatic duct carries bile out of the liver, formed where the right and left hepatic ducts meet; it is at risk during gallbladder surgery. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=abdomen&select=common_hepatic_duct&side=r) Opens in the Durgical app, no sign-up needed. ## What it is The duct formed by the right and left hepatic ducts, carrying bile from the liver. ## What it does Joins the cystic duct to form the [common bile duct](https://durgical.com/en/anatomy/bile-duct/). ## Key points - Medial side of the hepatocystic (Calot) triangle; with the right hepatic artery usually crossing behind it, it is the structure most at risk in a difficult cholecystectomy - Hilar cholangiocarcinoma (Klatskin tumour) arises at the confluence of the right and left hepatic ducts; the Bismuth–Corlette classification grades how far it reaches into them - The hepatic duct confluence lies outside the [liver](https://durgical.com/en/anatomy/liver/) at the hilum, under the hilar plate, in front of the portal vein bifurcation ## Key facts **Where** About 3–4 cm, from porta hepatis down the hepatoduodenal ligament; border of hepatocystic (Calot) triangle **Function** Carries bile out of the liver **Drains** Liver, via union of right and left hepatic ducts **Into** Joins cystic duct to form common bile duct ## Relations **Course** Formed at the porta hepatis by the right and left hepatic ducts, it descends in the hepatoduodenal ligament until the [cystic duct](https://durgical.com/en/anatomy/cystic-duct/) joins it **Behind** Right hepatic artery, which usually crosses behind it (in front of it in a minority); the [portal vein](https://durgical.com/en/anatomy/hepatic-portal-vein/) further back **Medial** [Proper hepatic artery](https://durgical.com/en/anatomy/proper-hepatic-artery/), on its left in the hepatoduodenal ligament **Lateral** Cystic duct and [gallbladder](https://durgical.com/en/anatomy/gallbladder/) neck, on its right ## How to find it It cannot be felt. In open surgery it lies in the free edge of the [lesser omentum](https://durgical.com/en/anatomy/lesser-omentum/) above the cystic duct junction, to the right of the hepatic artery and in front of the portal vein; at cholecystectomy it is the medial side of the hepatocystic triangle, kept in view but not dissected. ## On imaging On ultrasound the duct lies in front of the portal vein at the hilum; when dilated, the two run side by side as parallel tubes (double-barrel or shotgun sign). MRCP maps the confluence and its variants and shows the level of a block before surgery or drainage. ## Common problems - A gallstone stuck in it: jaundice, pain, and sometimes infection (cholangitis) or pancreatitis. - Injury during cholecystectomy (rare but serious). ## How it is diagnosed Blood tests, ultrasound, MRI (MRCP). ## Treatment - Stones removed by ERCP (an endoscope through the mouth to the [duodenum](https://durgical.com/en/anatomy/duodenum/)), then usually cholecystectomy. ## Clinical notes - Bile duct injuries are graded (Strasberg, Bismuth) by how close they come to the confluence; high injuries usually need a Roux-en-Y hepaticojejunostomy - Blocked hilar ducts can be drained from below by ERCP or from above through the liver by percutaneous transhepatic drainage ## Anatomical variants - The right posterior duct may join the left hepatic duct or the common hepatic duct directly; a low aberrant right duct is easily cut during cholecystectomy - Trifurcation: the right anterior, right posterior and left ducts meet at a single point instead of forming a right hepatic duct first ## Development The extrahepatic ducts come from the stalk of the hepatic diverticulum. In biliary atresia they are progressively destroyed in early infancy, causing jaundice with pale stools; a Kasai portoenterostomy at the hilum is the first operation. ## Related conditions - [Choledocholithiasis](https://durgical.com/en/conditions/choledocholithiasis/) - [Acute cholangitis](https://durgical.com/en/conditions/acute-cholangitis/) - [Primary sclerosing cholangitis](https://durgical.com/en/conditions/primary-sclerosing-cholangitis/) - [Cholangiocarcinoma (bile duct cancer)](https://durgical.com/en/conditions/cholangiocarcinoma/) - [Choledochal cyst](https://durgical.com/en/conditions/choledochal-cyst/) - [Biliary atresia](https://durgical.com/en/conditions/biliary-atresia/) ## Test yourself Think of the answer, then tap the question to see it. ## Which artery usually crosses behind the common hepatic duct? The right hepatic artery; with the duct on the medial side of Calot triangle, both are at risk in a difficult cholecystectomy. ## What is a Klatskin tumour? A hilar cholangiocarcinoma at the confluence of the right and left hepatic ducts; Bismuth–Corlette grades its spread into them. ## What is the double-barrel (shotgun) sign on ultrasound? A dilated common hepatic duct running parallel in front of the portal vein at the hilum. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/anatomy/common-hepatic-duct/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** ductus hepaticus communis TA2 3092 **Official Spanish (DeCS)** Conducto hepático común DeCS D006500 **English (TA2)** Common hepatic duct ## Related - [Cystic duct](https://durgical.com/en/anatomy/cystic-duct/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=6653&filter=ths_termall&q=Conducto%20Hep%C3%A1tico%20Com%C3%BAn); [Anatomy, Abdomen and Pelvis: Biliary Ducts](https://www.ncbi.nlm.nih.gov/books/NBK459246/); [23.6 Accessory Organs in Digestion: The Liver, Pancreas, and Gallbladder](https://openstax.org/books/anatomy-and-physiology-2e/pages/23-6-accessory-organs-in-digestion-the-liver-pancreas-and-gallbladder) (OpenStax (Rice University), 2022) · adapted, [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/common-hepatic-duct/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/common-hepatic-duct/