An anatomical diagram illustrating the human biliary tree and its relationship to adjacent hepatobiliary structures. The diagram depicts the biliary drainage system (colored green) beginning with the common bile duct, which receives the cystic duct from the gallbladder. Superior to this confluence is the common hepatic duct, which bifurcates into the right and left hepatic ducts. The right hepatic duct further branches into the right anterior (supplying segments 5 and 8) and right posterior (supplying segments 6 and 7) hepatic ducts. The left hepatic duct provides drainage for segments 1, 2, 3, and 4. Vascular landmarks are also shown: the portal vein (colored blue) is situated posterior to the common bile duct, and the right hepatic artery (colored red) is seen crossing posterior to the common hepatic duct. The gallbladder is positioned alongside the duodenum, with its cystic duct connecting to the main biliary channel. This diagram serves as a pedagogical tool for understanding segmental liver anatomy and surgical landmarks in the porta hepatis.

A split-view image consisting of a clinical photograph and a corresponding anatomical illustration demonstrating the placement of a biliary stent within the common bile duct (CBD). Left: A grayscale laparoscopic image shows a surgical field within the hepatic hilum. A cylindrical, tubular biliary stent is visible, positioned antegrade within the bile duct to maintain patency. Laparoscopic instruments, including a grasper or probe, are visible in the foreground, indicating an active minimally invasive procedure. The surrounding tissue shows signs of surgical dissection, likely in the context of Mirizzi syndrome management. Right: A detailed medical illustration provides a schematic view of the biliary anatomy. It depicts the CBD containing the stent, the confluence of the hepatic ducts, and the relationship of the biliary tree to the duodenum and pancreas. The diagram highlights the intraluminal positioning of the stent and the anatomical landmarks essential for identifying cholecystobiliary fistulas. This visual pair serves as a guide for surgical trainees in understanding laparoscopic biliary decompression and reconstruction techniques.

This composite educational graphic details hepatobiliary anatomy and the interventional management of biliary strictures. Panel A is an anatomical diagram of the liver and biliary tree, labeling the left and right hepatic ducts, common hepatic duct (CHD), cystic duct, and common bile duct (CBD). Panel B is a fluoroscopic image from an endoscopic retrograde cholangiopancreatography (ERCP) demonstrating a high-grade stricture in the common hepatic duct (indicated by an arrow). A guide wire and stent catheter are seen traversing the narrowed segment to maintain access. Panel C shows the follow-up fluoroscopy after the deployment of a self-expanding metal (SEM) stent (highlighted by a green circle). The SEM stent has successfully dilated the CHD stricture, restoring ductal patency to alleviate cholestasis. The images highlight the clinical progression from diagnostic identification of extrahepatic bile duct obstruction to therapeutic resolution using interventional gastroenterology techniques.

This composite educational image includes contrast-enhanced computed tomography (CT) scans (a-c) and a schematic diagram (d) illustrating an intrabiliary mass. The axial CT sections demonstrate significant intrahepatic bile duct dilatation in the right lobe, specifically in the posterior segment extending toward the hepatic confluence. A single arrow in panels a and b indicates the dilated ductal system, while multiple arrows in panel c highlight a low-density intraluminal mass causing the obstruction. The schematic diagram (d) maps the biliary anatomy, showing the convergence of the anterior right hepatic duct (Bant), posterior right hepatic duct (Bpost), and left-sided ducts from segments B2, B3, and B4. The diagram identifies the tumor location ('mass') at the confluence involving the common hepatic duct. A percutaneous transhepatic biliary drainage (PTBD) catheter is depicted in situ, and the spatial relationship to the gallbladder and common bile duct is shown. This visual set is used to teach diagnostic recognition of biliary tumors, such as intrahepatic cholangiocarcinoma or metastatic intrabiliary growth, and their radiographic presentation.

This endoscopic clinical photograph captures a biliary stone extraction procedure during an Endoscopic Retrograde Cholangiopancreatography (ERCP). The central focus is on several large choledocholiths (bile duct stones) being retrieved from the common bile duct. The stones exhibit a characteristic dark green to brownish-black pigmentation, suggestive of bile staining, with a notably coarse and irregular surface texture. Reflection of the light source creates bright specular highlights on the moist surface of the calculi. A white, flexible, cylindrical balloon-tipped catheter with dark orientation markings is visible in the foreground, utilized to sweep and mobilize the stones into the duodenum. The surrounding duodenal mucosa and ampullary region are partially visible, appearing erythematous and typical for the clinical context of biliary obstruction and intervention. This image serves as a visual demonstration of therapeutic endoscopy in the management of choledocholithiasis and obstructive jaundice.

This endoscopic clinical photograph demonstrates a biliary stone extraction procedure during an Endoscopic Retrograde Cholangiopancreatography (ERCP). The primary visual focus is a large, irregularly shaped choledocholith (biliary stone) being retrieved from the common bile duct. The stone exhibits a predominantly yellow-brown, ochre-like coloration with a rough, granular surface texture, characteristic of a mixed cholesterol and pigment stone. A mechanical retrieval device, specifically a wire-guided stone extraction basket, is visible with its thin metal wires tightly encompassing the stone to secure it for passage through the papilla into the duodenal lumen. The background shows the pinkish, mucosal lining of the gastrointestinal tract and the transparent distal attachment (cap) of the endoscope used for better visualization and tissue retraction. This image illustrates the therapeutic management of choledocholithiasis and the use of specialized endoscopic accessories in hepatobiliary intervention.

A multi-modal image series documenting the diagnosis and management of choledocholithiasis via Endoscopic Retrograde Cholangiopancreatography (ERCP). Image (a) is a cross-sectional CT scan showing a hyperdense, 5mm stone in the distal common bile duct (CBD). Images (b, d, f) provide endoscopic views showing biliary cannulation with a guidewire, endoscopic sphincterotomy of the papilla, and mechanical stone extraction using a Dormia basket. Images (c, e, g) are fluoroscopic cholangiograms. (c) demonstrates a radiolucent filling defect in the distal CBD representing the stone. (e) shows the ductal anatomy post-sphincterotomy, and (g) confirms successful stone clearance with a balloon-occlusion cholangiogram showing no residual filling defects. The series illustrates the standard interventional sequence: identification, cannulation, sphincterotomy, extraction, and final clearance verification.