Gallbladder

Anatomy and gallbladder topography

Left and right hepatic ducts at merge in a place of an exit from liver shares form the general hepatic duct (length 3-4 centimetres).

General cholic duct is located lateralis in relation to the general hepatic artery and to front from a portal vein.

General cholic duct has four parts:

1. supraduodenal (from merge of the general hepatic with a vesical duct to external edge of a duodenum)
2. Retroduodenal (from external edge of a duodenum to a pancreas head)
3. Pancreatic (passing behind a head of a pancreas or through its parenchyma)
4. Intramural (passing in a depth of a wall of a duodenum)

The duct in a duodenum on Major duodenal papilla opens.

Variants of bond of the general cholic and pancreatic ducts:

• Approach to a duodenum in the form of a uniform duct
• Ducts are bridged in a duodenum wall
• The general cholic and pancreatic ducts run into a duodenum separately

Sphincter of Oddi the general cholic duct it is located in a place of passage of a duct through an ampoule papilla duodeni major; regulates bile entering in a duodenum.

Blood supply of cholic ducts:

• Intrahepatic ducts receive blood immediately from hepatic arteries
• Blood supply supraduodenal parts of the general cholic duct variable. In most cases the blood flow is referred from portal fissures. The vessels laying along the edges of a cholic duct on 3 and 5 hours are most significant

Gallbladder is in a vesical fossa on the bottom surface of a liver. It serves as a reference point of border of the right share of a liver.

Anatomic parts of a gallbladder: a bottom, a body, Hartmann’s pouch (it is located between a neck and a body of the gallbladder - the part of a bubble located behind).

Gallbladder wall consists of smoothly muscular cells and a connecting tissue. A lumen inlay a high cylindrical epithelium.

Gallbladder blood supply:

• Arterial blood arrives to a gallbladder on a cholecystis artery - branches of the right hepatic artery (less often than actually hepatic artery)
• Venous outflow from a gallbladder occurs mainly on the vesical vein running into a portal vein
• Lymph from a gallbladder flows off both in a liver, and in lymph nodes of portal fissures
• Vesical duct, the general hepatic duct and vesical artery form triangle Calot. Cholic ways have the sphincters regulating a biliary excretion: sphincter Lutkens in a gallbladder neck, sphincter Mirizzi in a place of merge of vesical and general cholic ducts

Innervation:

• Impellent innervation is carried out by means of fibers of a vagus nerve and postganglionic fibers from celiac ganglions. Level of a preganglionic sympathetic innervation - Th8-Th9
• Sensitive innervation is carried out by sympathetic fibers from radicular ganglions at level Тh8-Th9

Valves Highster - cords of a mucosa of a vesical duct. Despite the name, they do not carry valval functions.