Biliary System (Anatomy/Congenital Defects)

Normal length and trv diameter of the gallbladder

• transverse diameter < 5 cm

• length < 10 cm

What connects the right portal vein to the GB neck?

the main lobar fissure

Where is the GB located ? where’s the GB fossa?

GB

• RUQ

• bordered by rt kidney and duodenum

• inferior end of main lobar fissure

• GB fossa → posteroinferior rt lobe liver

what artery supplies the gallbladder?

what vein drains the gallbaldder?

• cystic artery supplies

• cystic vein drains into the RPV

Where does the cystic artery originate from?

right hepatic artery

normal thickness of GB

< 3 mm

what conditions does increased GB wall thickness suggest?

• -itis , inflammation

  • cholecystitis

  • hepatitis

  • pancreatitis

• systemic issues

  • congestive heart failure

  • AIDS

what kind of vessels are the bile ducts?

intrasegmental, intralobar because they course through the liver adjacent to the portal vein branches and the HA branches

What supplies the biliary tree with blood supply?

• hepatic arteries → supply the intrahepatic ducts and the middle part of the CHD

• cystic artery → supplies prox CHD and GB

• gastroduodenal and pacnreaticoduodenal arcade supply distal CHD

CHD is formed by the jxn of ?

Joins what to form the CBD?

• CHD is formed by the right and left hepatic ducts

• joins the cystic duct to form the CBD

Cystic duct + CHD = ?

CBD

Normal CBD diameter

• patients with GB = less than 8 mm

• patients without GB = less than 12 mm

CBD diameter can correlate with a patient’s age. How many mm does it increase for each decade of life?

• 1 mm [example = 60 y/o will have a 6 mm duct]

• elderly patients can have a normal CBD at 10 mm

GB anatomy

refer to image