Common hepatic duct

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A Moment in History

Jean Louis Petit
(1674 – 1750)

French surgeon and anatomist, Jean Louis Petit was born in Paris in on March 13, 1674. His family rented an apartment at his house to Alexis Littre (1658 – 1726), a French anatomist. Petit became an apprentice of Littre at seven years of age, helping him in the dissections for his lectures and at an early age became the assistant in charge of the anatomic amphitheater.

Because of Petit’s dedication to anatomy and medicine, in 1690 at the age of sixteen, became a disciple of a famous Paris surgeon, Castel.

In 1692, Petit entered the French army and performed surgery in two military campaigns. By 1693 he started delivering lectures and was accepted as a great surgeon, being invited to the most difficult operations. In 1700 he was appointed Chief Surgeon of the Military School in Paris and in the same year he received the degree of Master of Surgery from the Faculty of Paris.

In 1715 he was made a member of the Royal Academy of Sciences and an honorary member of the Royal Society of London. He was appointed by the King as the first Director General of the Royal Academy of Surgery when it was founded in 1731.

Petit’s written works are of historical importance. “Traite des Maladies des Os” ( A Treatise on Bone Diseases); “Traite des Maladies Chirurgicales et des Operation” (A Treatise on Surgical Diseases and their Operations” This last book was published posthumously in 1774. He also published a monograph on hemorrhage, another on lachrymal fistula, and others.

He was one of the first to perform choIecystotomy and mastoidotomy. His original tourniquet design for amputations saved many in the battlefield and the design of the same surgical instrument today has not changed much since its invention by him.

His name is remembered in the lumbar triangle, also called the "triangle of Petit", and the abdominal hernia that can ensue through that area of weakness, the lumbar hernia or "Petit's hernia".

Sources:
1. “Jean Louis Petit – A Sketch of his Life, Character, and Writings” Hayne, AP San Fran Western Lancet 1875 4: 446-454
2. “Oeuvres compl?tes de Jean-Louis Petit” 1837 Imprimerie de F. Chapoulaud
3. Extraits de l'eloge de Jean-Louis Petit Ius dans Ia seance publique de I' Academie royale de chirurgie du 26 mai 1750” Louis A. Chirurgie 2001: 126 : 475- 81

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Common hepatic duct

Published: Wednesday, July 22, 2015 07:00 | Written by: Efrain A. Miranda, Ph.D. | Hits: 4948

The [common hepatic duct] is one of the components of the extrahepatic hepatobiliary tree that takes bile produced in the liver and transports it to the duodenum, with a storage function in the gallbladder.

The common hepatic duct (CHD) is formed by the junction of the right and left hepatic ducts which bring bile from the right and left functional lobes of the liver respectively. These hepatic ducts converge forming an obtuse angle.

During its trajectory the CHD is found between the layers of the lesser omentum. It has anatomical relations with the proper hepatic artery and the portal vein.

The CHD has an average diameter of 4 to 5 mm and an average length of 3cm (Testut & Latarjet 1931). It ends at the point of origin of the cystic duct which takes bile to the gallbladder. The CHD continues with the common bile duct, which empties into the second portion of the duodenum through the hepatopancreatic ampulla, also known as the Ampulla of Vater.

1. Bile ducts: 2. Intrahepatic bile ducts 3. Left and right hepatic ducts, 4. Common hepatic duct 5. Cystic duct 6. Common bile duct 7. Ampulla of Vater 8. Major duodenal papilla 9. Gallbladder 10–11 Right and left lobes of liver 12. Spleen. 13. Esophagus 14. Stomach Small intestine: 15. Duodenum, 16. Jejunum 17. Pancreas: 18: Accessory pancreatic duct, 19: Pancreatic duct. 20–21: Right and left kidneys (silhouette). The anterior border of the liver is lifted superiorly (brown arrow). Gallbladder in longitudinal section, pancreas and duodenum in frontal section. Intrahepatic ducts and stomach in transparency.

1. Bile ducts: 2. Intrahepatic bile ducts 3. Left and right hepatic ducts, 4. Common hepatic duct 5. Cystic duct 6. Common bile duct 7. Ampulla of Vater 8. Major duodenal papilla 9. Gallbladder 10–11 Right and left lobes of liver 12. Spleen. 13. Esophagus 14. Stomach Small intestine: 15. Duodenum, 16. Jejunum 17. Pancreas: 18: Accessory pancreatic duct, 19: Pancreatic duct. 20–21: Right and left kidneys (silhouette). The anterior border of the liver is lifted superiorly (brown arrow). Gallbladder in longitudinal section, pancreas and duodenum in frontal section. Intrahepatic ducts and stomach in transparency.

As with all the components of the hepatobiliary tree, the CHD presents with many anatomical variations. In cases the CHD has been reported with a length of 42 mm, and as short as 3 mm.

Sources:
1. "Tratado de Anatomia Humana" Testut et Latarjet 8 Ed. 1931 Salvat Editores, Spain
2. "Gray's Anatomy" 38th British Ed. Churchill Livingstone 1995
Original image by Jmarchn (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons

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