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
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