GALLBLADDER & EXTRAHEPATIC BILIARY TREE

Dr. Benjamín Robles Mariscal

Dr. Héctor Manuel Virgen Ayala

Clínicas quirúrgicas

Brenda de la Torre Aguayo 209340718

UNIVERSIDAD DE GUADALAJARA Centro Universitario de Ciencias de la Salud

Embryology

• Development of the liver and biliary structures begins during the fourth week of fetal life.

– Caudal portion

ANATOMY

InervaciónMotor innervation. T8 T9

Sensory innervation

Valves of Heister

Anatomy

Physiology

• Bile…produce by the liver, transported to the gallbladder and released in response to humoral and neural control

• Hepatic production: 600 mL

Composition of bile 1 Electrolytes and water

2 Bile pigments

3 Protein

4 Lipids

a) Phospholipids, primarily lecithin

b) Cholesterol

c) Bile acids (bile salts): chenodeoxycholic acid and cholic acid conjugates with taurine and glycine

Functions of the gallbladder

Storage of bile

Concentration of bile • Absorption of water • Secretion of mucus

Release of bile • Simultaneous contraction of the gallbladder and

relaxation of the sphincter of Oddi • CCK

RADIOLOGIC DIAGNOSIS OF BILIARY TRACT DISEASE

Plain abdominal films

Real time ultrasonography

Hepatobiliary iminodiacetic acid (HIDA) scan

Endoscopic retrograde cholangiopancreatography (ERCP)

1 Common bile duct

2 Common hepatic duct

3 Cystic duct

4 Endoscope in duodeno

5 Gallbladder

6 Amper´s ampulla

7 Left hepatic duct

8 Neck of gallbladder

9 Pancreatic duct

10 Right hepatic duct

MRI / CT

GRACIAS THANK YOU