Gallbladder

A hollow muscular organ, present in humans and most vertebrates, which receives dilute bile from the liver, concentrates it, and discharges it into the duodenum. It also participates in the entero-hepatic (re)circulation of bile, and in secretion and removal of conjugated xenobiotics, including radiopaque substances taken orally or intravenously for diagnostic purposes. Although not a vital organ, it stores bile, regulates biliary tract pressures, and, when diseased, enhances precipitation of various constituents of the bile as gallstones.

The system of bile ducts lying outside the liver is known as the extrahepatic biliary tract. In humans (Illus.) right and left hepatic ducts empty into the common hepatic duct, which continues to the duodenum as the common bile duct, or ductus choledochus. The gallbladder and cystic duct thus appear to be accessory organs and therefore are removable. However, they are converted into main-line structures by the presence of a sphincter (sphincter of Oddi) at the choledochoduodenal junction. Tonic contraction of this sphincter between meals forces the bile to back up into the gallbladder.

Extrahepatic biliary tract in humans

In most other vertebrates essentially similar relations exist except when the gallbladder is absent, but there is considerable variation in proportion and arrangement of ducts, including the pancreatic ducts. See Liver, Pancreas

In humans, evacuation of the gallbladder is accomplished by a trigger mechanism which is set off by the presence of fatty foods, meat, and hydragogue cathartics in the duodenum and upper jejunum. Absorption of these substances by the mucous membrane results in the release of cholecystokinin (CCK), a hormone which rapidly circulates in the bloodstream and simultaneously produces contraction of the gallbladder and relaxation of the sphincter of Oddi. The most effective food is egg yolk, which contains certain l-amino acids. Resorption of bile salts by the intestine stimulates secretion of bile for hours after a meal. See Digestive system

Gallbladder

the organ of vertebrate animals and man in which bile accumulates. The degree of gallbladder development is determined by the nutritional method of the organism. In predatory animals, whose diet contains much fat, it is better developed than in herbivores. The gallbladder is usually located in the liver itself or is close to it and has an effluent duct, which, merging with the effluent duct of the liver, forms the bile duct, which opens into the duodenum. Some animals have two hepatic ducts: one of them, the hepatocystic duct, connects directly with the gallbladder; the other either opens into the cystic duct (usually the case) or directly into the duodenum and is then called the hepatoenteric duct. A gallbladder is present in hagfish and the larvae of lampreys, the majority offish, all amphibians and reptiles, and the majority of birds. (It is especially large in predators.) Among mammals, the gallbladder is absent in many rodents (mice, rats, and hamsters), whales, elephants, and perissodactyls (horses, tapirs, and rhinoceroses), and some artiodactyls (deer and camels).

In man the gallbladder is a thin-walled, pear-shaped pouch 10-14 centimeters (cm) long and 3.5-4 cm wide, with a capacity of 30-70 cm3. It is located on the lower surface of the liver, with which it is connected by porous tissue. The wall of the gallbladder consists of mucous, muscular, and serous coats. Gradually narrowing, the gallbladder becomes the cystic duct, which merges with the hepatic duct to form the common bile duct; this, together with the pancreatic duct, empties into the duodenum. Bile produced in the liver is carried through the hepatic duct into the gallbladder. Contractions of the gallbladder musculature, induced by the entrance of bile into the duodenum, begin as a result of the effect of stimuli connected with food intake and are repeated periodically during digestion. [9-474.2]

gallbladder

[′gȯl‚blad·ər] (anatomy) A hollow, muscular organ in humans and most vertebrates which receives dilute bile from the liver, concentrates it, and discharges it into the duodenum.

gallbladder

[gawl´blad-er] the pear-shaped organ located below the liver. It serves as a storage place for bile.Diagnostic Studies. Laboratory tests helpful in the diagnosis of gallbladder and biliary tract diseases include evaluation of direct bilirubin and alkaline phosphatase, both of which are elevated in biliary tract disease. The presence of bile in the urine is indicative of biliary obstruction.
One of the most common radiologic techniques for diagnosis of gallbladder disease is ultrasonography. It is a noninvasive procedure that can help differentiate between biliary obstruction and liver disease. Abnormal patterns on the graph can show an enlarged gallbladder, obstruction of the common bile duct, dilatation in the biliary tree, and the presence of stones in the gallbladder and common bile duct. Ultrasonography has the advantages of being quick, requiring no special preparation of the patient, and avoiding the risks of exposure to radiation from x-rays.
Another commonly used radiologic study is radionuclide imaging, using an intravenous injection of ⁹⁹Tc iminodiacetic acid (HIDA) or some other radioisotope that has an affinity for the biliary tree and concentrates at that site.
Oral cholecystography, in which an iodinated radiopaque contrast medium is ingested, absorbed by the intestines, and excreted by the liver in the bile, is useful in opacification of the gallbladder. However, this method can be used only in patients without acute symptoms.
Percutaneous transhepatic cholangiography can be used to visualize the biliary ducts in jaundiced patients. A needle is inserted through the skin into the liver. The contrast medium is then injected into the liver and subsequently excreted in the biliary system. Obstructions and distention of the bile ducts can thus be observed, after which the ducts are drained of bile that has accumulated behind the obstruction.
When a suspected disorder of the gallbladder cannot be identified by any of the above procedures, the physician may choose to perform endoscopic retrograde cholangiopancreatography (ERCP). Under fluoroscopic control the endoscope is inserted into the mouth and guided through the esophagus and down to the descending duodenum. Cannulas are then directed through the endoscope and placed in the common bile duct; through them a contrast medium is injected into the ducts so that they can be inspected by fluoroscopy.
Unfortunately, none of the diagnostic tests is completely reliable, and between 5 and 10 per cent of patients with biliary disease have repeated normal test values. Many such patients eventually have exploratory surgery because of persistence of symptoms. In such cases the gallbladder is often inflamed but without stones, or it may contain grains of sand too small to be visualized by the testing procedures.Surgery of the Gallbladder and the Biliary Tree. The most common operation on the biliary system is cholecystectomy, the removal of the gallbladder. cholecystostomy, or drainage of the gallbladder, is rarely done today. choledochotomy, exploration of the common bile duct, is indicated if there are stones or a tumor obstructing the major drainage system. The duct is generally explored directly, but in difficult cases it may be approached through the wall of the duodenum.
Biliary surgery is usually followed by leakage of bile from the repaired common duct or from the gallbladder bed. Accordingly, many surgeons drain the gallbladder bed with a soft drain for several days. If the common duct is opened, drainage of bile can be accomplished by the insertion of a T-tube, which decompresses the common duct until it is healed. T-tubes are generally left in place for 10 days or more in order to develop a tract through which bile can drain after the T-tube is removed. A T-tube cholangiogram is usually performed prior to the removal of the tube in order to determine that the common bile duct is patent and free of stones. If stones are found, they can be removed through the tube tract by instruments inserted under x-ray control.
Minimally invasive techniques of surgery are dramatically changing cholecystectomy. Laser and endoscopic procedures to remove the gallbladder do not require insertion of a T-tube.

T-tube placement in gallbladder surgery. The surgeon ties off the cystic duct and sutures the T-tube into the common bile duct, with the short arms of the T-tube toward the hepatic duct and duodenum. The long arm of the T-tube exits the body near the incision site. Skin suture and tape secure placement. From Polaski and Tatro, 1996.

gall·blad·der

(gawl'blad-ĕr), [TA] A pear-shaped organ on the inferior surface of the liver, in a hollow between the right lobe and the quadrate lobe; it serves as a storage reservoir for bile. Synonym(s): vesica biliaris [TA], vesica fellea ☆ , bile cyst, cholecyst, cholecystis, cystis fellea, gall bladder, vesicula fellis

gallbladder

also

gall bladder

(gôl′blăd′ər)n. A small, pear-shaped muscular sac under the right lobe of the liver, where bile secreted by the liver is stored until needed by the body for digestion.

gall·blad·der

(gawl'blad-ĕr) [TA] A pear-shaped receptacle on the inferior surface of the liver, in a hollow between the right lobe and the quadrate lobe; it serves as a storage reservoir for bile.
Synonym(s): vesica biliaris [TA] , cholecyst, cholecystis.

Gallbladder

A small, pear-shaped organ in the upper right hand corner of the abdomen. It is connected by a series of ducts (tube-like channels) to the liver, pancreas, and duodenum (first part of the small intestine). The gallbladder receives bile from the liver, and concentrates and stores it. After a meal, bile is squeezed out of the gallbladder into the intestine, where it aids in digestion of food.Mentioned in: Cholecystectomy, Wilson Disease

Patient discussion about gallbladder

Q. how people deal with after gallbladder removal A. REMOVE BOTH STONES & GALLBLADDER

Q. What arethe pros and cons of removingmy gallbladder due to gallstones A. Pro - solves the problem (gallstones usually don't form in the absence of gall bladder
Cons - operation, with its complications: anesthesia, incision, hernia in the incision, infection etc.
Usually there are no chronic consequences for the absence of gallbladder.
However, this is only general advice - if you have any questions regarding this subject, you should consult a doctor (e.g. general surgeon).
You may read more here:
http://www.nlm.nih.gov/MEDLINEPLUS/ency/article/002930.htm

Q. What is involved in Gall Bladder surgery? A. If you refer to removal of the gal bladder due to stones, then it may be performed either in an open approach (using an arch-like incision in your right upper abdomen) or in a laparoscopic approach (using only three small incisions to insert devices into your abdomen). The operation itself is not long and not associated with significant problems after it.

More discussions about gallbladder

gallbladder

gall·blad·der

gallbladder

gall′blad`der

or gall′ blad`der,

gall·blad·der

gallbladder

Gallbladder

Gallbladder

Gallbladder

gallbladder

gallbladder

gallbladder

gall·blad·der

gallbladder

gall bladder

gall·blad·der

Gallbladder

Patient discussion about gallbladder

gallbladder

Synonyms for gallbladder

noun a muscular sac attached to the liver that stores bile (secreted by the liver) until it is needed for digestion

Synonyms

Related Words