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A practical reappraisal of the anatomy of the extrahepatic bile ducts and arteries

Two hundred and five dissections of the extrahepatic biliary tree have revealed that although the anatomy of this area is remarkably variable there are only three important vascular and five important ductal anomalies (the former occurring much more frequently than the latter). Each anomaly is, however, easily recognized at operation. A higher incidence of anatomical anomalies was found in patients with gallstones compared with those without and in women than in men, and there was a remarkably low incidence of accessory hepatic ducts overall. The significance and practical implications of these findings are discussed.