Subvesical bile ducts

Last revised by Dr Yuranga Weerakkody on 20 Nov 2020

Subvesical subvesicular bile ducts are variants of the biliary tree, and knowledge of these are important because they account for a significant portion of post-cholecystectomy bile leaks

Cholecystohepatic ducts (usually segment 5 to the gallbladder) are commonly known as bile duct(s) of Luschka but this terminology is not favored because the original description does not fit with the current knowledge of variant biliary tree anatomy 1.  

Four types of subvesical bile ducts have been described 1, although there is variability in the literature:

  • segmental / sectorial subvesical bile duct
    • variant bile duct with a superficial course along the gallbladder fossa
    • this is a normal bile duct in segment 5 or 8 that courses near the gallbladder without contacting it
    • drains into the right anterior sector duct (RASD) or right posterior sector duct (RPSD)
  • accessory subvesical bile duct
    • additional duct usually arising from segment 5 or 8, coursing superficially along the gallbladder fossa and draining into the common bile duct (or rarely into the cystic duct)
  • cholecystohepatic bile duct
    • (often segment 5) bile duct that connects the gallbladder to a larger biliary sectorial duct
  • aberrant subvesical bile duct
    • a mesh of small bile ducts in the liver parenchyma of the gallbladder fossa draining into small intrahepatic bile ducts

Both cholecystohepatic and aberrant subvesical bile ducts have been described as bile ducts of Luschka 2.

Subvesical bile ducts may occasionally be seen on ERCP (sometimes intraoperative ERCP), but damage to cholecystohepatic ducts is often inferred from a postcholecystectomy bile leak, which may be detected through cholescintigraphy.

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Cases and figures

  • Case 1: bile leak from subvesiclaebile duct post cholecystectomy
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