Aberrant biliary ducts (vasa aberrantia): Surgical implications

Abstract

Aberrant biliary ducts (vasa aberrantia) represent a morphological anomaly rather than an anatomical variation of the biliary tree. They have been recognised by anatomists for many years. They are inconstant but fairly frequent and are situated on the surface of the liver in a fibrous envelope or are to be found suspended, in particular in the left triangular ligament. One of them is the sub vesicular duct (ductus subvesicalis), situated in the gallbladder fossa and accounts for more than a third of cases. The vasa aberrantia are in continuity with the intrahepatic bile ducts but they appear to have lost their relationship with the hepatic parenchyma, draining no particular region of the liver. They are not accompanied by arteries and veins which together with the bile ducts normally constitute the portal triad. The vasa aberrantia should be known by surgeons because their existence can sometimes explain the origin of certain cases of biliary peritonitis or on occasions a choleperitonitis following the section of the left hepatic triangular ligament. The frequency of a subvesicular duct is such as to justify routine drainage of the gallbladder bed following cholecystectomy.