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Arch Surg. 2008;143(11):1128.

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Answer: Subvesical Bile Duct (Luschka) Leak

Subvesical bile ducts of Luschka were first described by the German anatomist Herbert von Luschka in 1863.¹ In the strictest definition, these ducts usually range in size from 1 to 2 mm in diameter and course through the gallbladder fossa to empty into the right hepatic or common hepatic duct.² While ducts of Luschka are present in 3% to 5% of cadavers at autopsy,³ their true incidence is unknown. Recent articles describe symptomatic biliary leaks in approximately 0.1% to 0.5% of patients after open cholecystectomy.⁴ Of these symptomatic leaks, approximately 15% to 20% are attributed to ducts of Luschka.⁴ Identifying intraoperative damage to a duct of Luschka is difficult. Keeping close to the gallbladder wall during dissection is the best way to prevent injury. A careful visual inspection of the gallbladder fossa at the end of the operation may confirm the presence of a biliary leak.² Placing a dry gauze . . . [Full Text of this Article]

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Arch Surg. 2008;143(11):1127.
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