Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (788 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
The largest bile duct. It is formed by the junction of the cystic duct and the common hepatic duct.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Bile Duct, Common; Common Bile Ducts; Duct, Common Bile; Choledochus.
Where it fits in the MeSH classification
- Broader topics
- Bile Ducts, Extrahepatic
- Narrower topics
- Ampulla of Vater
- See also
- Choledochostomy
Related concepts
- Cystic Duct
- Common Hepatic Duct
Research landscape
PubMed indexes 20,296 records tagged with the MeSH heading “Common Bile Duct” (counts retrieved 2026-10-31). 1,614 of them (8.0%) were published from 2020 onward, and the busiest period so far is through 1999 with 13,168 records.
Reviews account for 1,316 records (6.5%) and meta-analyses for 124. Randomized controlled trials number 240 (1.2%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 13,168 |
| 2000-2009 | 2,704 |
| 2010-2019 | 2,810 |
| 2020 onward | 1,614 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 1,316 | 6.5% |
| Meta-analyses | 124 | 0.6% |
| Randomized controlled trials | 240 | 1.2% |
Method: PubMed query "Common Bile Duct"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.
Reading the evidence in anatomy and physiology
Anatomy describes how body structures are built and physiology describes how they normally work, so most findings here are descriptive or mechanistic rather than evidence about treatment. Much of what is known comes from dissection, imaging, tissue studies and experiments in animals, and measurements in healthy volunteers can differ from those in people with disease or at different ages. Normal ranges vary between individuals and populations. Check whether a result was measured in people or in another species, the age and health of the participants, and the method used.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
Ampullary Carcinoma: An Overview of a Rare Entity and Discussion of Current and Future Therapeutic Challenges [1]
Abstract reading summary — source excerpts
- Opening excerpt
- Ampullary carcinomas (ACs) represent a rare entity, accounting for approximately 0.
- Closing excerpt
- In this review, we will provide an overview of current evidence on AC, especially focusing on biological features, histological characteristics, and available data guiding present and future therapeutic strategies for these rare, and still barely known, tumors.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (88 words)
Ampullary carcinomas (ACs) represent a rare entity, accounting for approximately 0.2% of all gastrointestinal solid tumors and 20% of all periampullary cancers (PACs). Unfortunately, few data are available regarding the optimal therapeutic strategy for ACs due to their rarity, and physicians frequently encounter significant difficulties in the management of these malignancies. In this review, we will provide an overview of current evidence on AC, especially focusing on biological features, histological characteristics, and available data guiding present and future therapeutic strategies for these rare, and still barely known, tumors.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 34590592 · DOI · PMC8482111
HHLA2 is expressed in pancreatic and ampullary cancers and increased expression is associated with better post-surgical prognosis [2]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundHHLA2 is a recently discovered member of the B7-family of immune checkpoint molecules with limited expression in normal tissues but overexpression in several types of cancer.
- Closing excerpt
- ConclusionThe wide expression of HHLA2 in tumour cells and its association with cancer recurrence and patient survival suggest that HHLA2 represents a relevant immune checkpoint molecule in pancreatic and ampullary cancers.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (198 words)
BackgroundHHLA2 is a recently discovered member of the B7-family of immune checkpoint molecules with limited expression in normal tissues but overexpression in several types of cancer. The aim was to determine the expression, prevalence and biological relevance of HHLA2 protein expression in two closely related human cancer types, namely pancreatic cancer and ampullary cancer.MethodsHHLA2 expression levels were retrospectively determined by immunohistochemistry in tissue micro-arrays of surgically resected tumours of 122 pancreatic cancer patients and 72 patients with ampullary cancer of the pancreato-biliary subtype.ResultsHHLA2 was expressed at variable levels by tumour cells in 67% of pancreatic tumours and 93% of ampullary tumours. In the combined cohort high tumoural HHLA2 expression levels were significantly associated with delayed cancer recurrence and improved post-operative cancer-specific survival. The association of HHLA2 expression with cancer-specific survival and recurrence was statistically significant for the pancreatic cancer subgroup while a similar trend was found for the ampullary cancer subgroup. In multivariable analysis together with clinicopathologic characteristics, higher HHLA2 expression was an independent predictor of cancer-specific survival.ConclusionThe wide expression of HHLA2 in tumour cells and its association with cancer recurrence and patient survival suggest that HHLA2 represents a relevant immune checkpoint molecule in pancreatic and ampullary cancers.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 32071413 · DOI · PMC7156757
Cachexia, dietetic consultation, and survival in patients with pancreatic and periampullary cancer: A multicenter cohort study [3]
Abstract reading summary — source excerpts
- Opening excerpt
- It is unclear to what extent patients with pancreatic cancer have cachexia and had a dietetic consult for nutritional support.
- Closing excerpt
- Survival was comparable in patients with and without cachexia, but decreased in patients with more severe weight loss.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (246 words)
It is unclear to what extent patients with pancreatic cancer have cachexia and had a dietetic consult for nutritional support. The aim was to assess the prevalence of cachexia, dietitian consultation, and overall survival in these patients. This prospective multicenter cohort study included patients with pancreatic cancer, who participated in the Dutch Pancreatic Cancer Project and completed patient reported outcome measures (2015-2018). Additional data were obtained from the Netherlands Cancer Registry. Cachexia was defined as self-reported >5% body weight loss, or >2% in patients with a BMI 2 over the past half year. The Kaplan-Meier method was used to analyze overall survival. In total, 202 patients were included from 18 centers. Cachexia was present in 144 patients (71%) and 81 of those patients (56%) had dietetic consultation. Cachexia was present in 63% of 94 patients who underwent surgery, 77% of 70 patients who received palliative chemotherapy and 82% of 38 patients who had best supportive care. Dietitian consultation was reported in 53%, 52%, and 71%, respectively. Median overall survival did not differ between patients with and without cachexia, but decreased in those with severe weight loss (12 months (IQR 7-20) vs. 16 months (IQR 8-31), p = 0.02), as compared to those with <10% weight loss during the past half year. Two-thirds of patients with pancreatic cancer present with cachexia of which nearly half had no dietetic consultation. Survival was comparable in patients with and without cachexia, but decreased in patients with more severe weight loss.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 33107709 · DOI · PMC7774726
Incidence and risk factors for recurrence of ampullary adenomas after endoscopic papillectomy: Comparative analysis of familial adenomatous polyposis and sporadic ampullary adenomas in an international multicenter cohort [4]
Abstract reading summary — source excerpts
- Opening excerpt
- ObjectivesEndoscopic papillectomy (EP) is a minimally invasive therapy for the management of ampullary adenomas (AA).
- Closing excerpt
- These factors should be considered in decision-making with the patients.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (256 words)
ObjectivesEndoscopic papillectomy (EP) is a minimally invasive therapy for the management of ampullary adenomas (AA). We conducted this multicenter study to assess the incidence of and factors related to the recurrence of AA after EP in patients with familial adenomatous polyposis (FAP) compared to sporadic AA.MethodsWe included patients who underwent EP for AA at 10 tertiary hospitals. Adenomatous tissue at the resection site at the time of surveillance endoscopies was considered recurrent disease.ResultsIn all, 257 patients, 100 (38.9%) with FAP and 157 (61%) patients with sporadic AA, were included. Over a median of 31 (range, 11-61) months, recurrence occurred in 48/100 (48%) of patients with FAP and 58/157 (36.9%) with sporadic AA (P = 0.07). Two (2%) FAP patients and 10 (6.3%) patients with sporadic AA underwent surgery for recurrence. On multivariable regression analysis, the recurrence in FAP was higher than in sporadic patients after the first year of follow-up. AA size (hazard ratio [HR] 1.03, 95% confidence interval [CI] 1.001, 1.056), periampullary extension (HR 2.5, 95% CI 1.5, 4.01), and biliary duct dilation (HR 2.04, 95% CI 1.2, 3.4) increased the risk, while en bloc resection (HR 0.6, 95% CI 0.41, 0.9) decreased the risk of recurrence.ConclusionRecurrence rates are high after EP. Most recurrences in sporadic patients occur within the first year of follow-up, but after the first year of follow-up in patients with FAP. Recurrences are higher with larger adenomas, biliary duct dilation, and periampullary extensions, and may be mitigated by en bloc resection. These factors should be considered in decision-making with the patients.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 37985239 · DOI · PMC12136244
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline [5]
- Research article Papillary cannulation and sphincterotomy techniques at ERCP: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline [6]
- Research article Clinical practice guidelines for the management of biliary tract cancers 2019: The 3rd English edition [7]
- Research article Laparoscopic common bile duct exploration [8]
- Research article Endoscopic Ultrasound-Guided Biliary Drainage: A Systematic Review and Meta-Analysis [9]
- Research article Endoscopic management of ampullary tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline [10]
References
- Rizzo A, Dadduzio V, Lombardi L, Ricci AD, Gadaleta-Caldarola G. Ampullary Carcinoma: An Overview of a Rare Entity and Discussion of Current and Future Therapeutic Challenges. . 2021. PMID 34590592 · DOI · PMC8482111
- Boor PPC, Sideras K, Biermann K, Hosein Aziz M, Levink IJM, Mancham S, et al.. HHLA2 is expressed in pancreatic and ampullary cancers and increased expression is associated with better post-surgical prognosis. . 2020. PMID 32071413 · DOI · PMC7156757
- Latenstein AEJ, Dijksterhuis WPM, Mackay TM, Beijer S, van Eijck CHJ, de Hingh IHJT, et al.. Cachexia, dietetic consultation, and survival in patients with pancreatic and periampullary cancer: A multicenter cohort study. . 2020. PMID 33107709 · DOI · PMC7774726
- Singh AD, Burke CA, Draganov PV, Bapaye J, Nishimura M, Ngamruengphong S, et al.. Incidence and risk factors for recurrence of ampullary adenomas after endoscopic papillectomy: Comparative analysis of familial adenomatous polyposis and sporadic ampullary adenomas in an international multicenter cohort. . 2024. PMID 37985239 · DOI · PMC12136244
- Manes G, Paspatis G, Aabakken L, Anderloni A, Arvanitakis M, Ah-Soune P, et al.. Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy. 2019. PMID 30943551 · DOI
- Testoni PA, Mariani A, Aabakken L, Arvanitakis M, Bories E, Costamagna G, et al.. Papillary cannulation and sphincterotomy techniques at ERCP: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2016. PMID 27299638 · DOI
- Nagino M, Hirano S, Yoshitomi H, Aoki T, Uesaka K, Unno M, et al.. Clinical practice guidelines for the management of biliary tract cancers 2019: The 3rd English edition. J Hepatobiliary Pancreat Sci. 2021. PMID 33259690 · DOI
- Petelin JB. Laparoscopic common bile duct exploration. Surg Endosc. 2003. PMID 12958681 · DOI
- Khan MA, Akbar A, Baron TH, Khan S, Kocak M, Alastal Y, et al.. Endoscopic Ultrasound-Guided Biliary Drainage: A Systematic Review and Meta-Analysis. Dig Dis Sci. 2016. PMID 26518417 · DOI
- Vanbiervliet G, Strijker M, Arvanitakis M, Aelvoet A, Arnelo U, Beyna T, et al.. Endoscopic management of ampullary tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2021. PMID 33728632 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-10-31.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.