Alterations in Function of the Gallbladder and Exocrine Pancreas

Vocabulary flashcards highlighting key terms and definitions related to the gallbladder, bile, pancreatic function, and associated disorders, as presented in the lecture notes.

Pancreaticobiliary system

Integrated system consisting of the gallbladder, cystic duct, intra- and extrahepatic bile ducts, and the endocrine & exocrine pancreas that delivers bile and pancreatic juice to the intestine.

Gallbladder

Hollow organ that receives bile from the liver, concentrates it by absorbing water, and contracts to expel bile into the common bile duct.

Cystic duct

Small duct connecting the gallbladder to the common bile duct, allowing passage of stored bile.

Common bile duct

Duct that carries bile from the liver and gallbladder to the duodenum.

Endocrine pancreas

Portion of the pancreas that secretes insulin, glucagon, and somatostatin directly into the bloodstream.

Exocrine pancreas

Portion of the pancreas that secretes digestive juice (enzymes and bicarbonate) into the duodenum via the pancreatic duct.

Acini

Clusters of pancreatic exocrine cells that synthesize and secrete digestive enzymes.

Bile acids

Components of bile derived from cholesterol; combine with amino acids to form bile salts.

Bile salts

Conjugated bile acids essential for digestion and absorption of dietary fats in the small intestine.

Bile

Alkaline fluid containing bile salts, pigments, cholesterol, and phospholipids; major route for excretion of certain waste products.

Amylase

Pancreatic enzyme secreted in active form that digests starch; serum level rises in pancreatitis.

Lipase

Pancreatic enzyme secreted in active form that digests fats; serum level rises in tandem with amylase during pancreatitis.

Trypsinogen

Pancreatic proenzyme activated to trypsin in the duodenum; initiates protein digestion.

Cholecystokinin (CCK)

Hormone released from the small intestine that stimulates gallbladder contraction and pancreatic enzyme secretion.

Secretin

Hormone released from the duodenum that stimulates pancreatic bicarbonate secretion.

Cholelithiasis

Presence of gallstones, most often cholesterol stones, within the gallbladder; twice as common in women.

Pathophysiology of cholesterol gallstone formation

Process dependent on bile supersaturation with cholesterol, nucleation of crystals, and gallbladder hypomotility.

Cholecystitis

Inflammation of the gallbladder wall; may be acute or chronic and can progress to gangrene or rupture.

Acute cholecystitis

Sudden severe inflammation of the gallbladder characterized by right upper quadrant pain often radiating to the back.

Chronic cholecystitis

Persistent gallbladder inflammation due to repeated irritation from stones or recurrent acute attacks; may cause porcelain gallbladder.

Intermittent biliary colic

Recurrent epigastric or right upper abdominal pain linked to transient cystic duct obstruction in chronic cholelithiasis.

Porcelain gallbladder

Calcified, scarred gallbladder wall resulting from chronic cholecystitis; predisposes to carcinoma.

Biliary malignancy

Rare cancer (1–2 per 100,000/yr) presenting with right upper quadrant pain and obstructive jaundice.

Pancreatic enzymes

Digestive enzymes (e.g., amylase, lipase, trypsinogen) secreted by the exocrine pancreas; release stimulated by CCK and secretin.

Acute pancreatitis

Inflammatory process of the pancreas ranging from mild to life-threatening; commonly linked to alcohol, ductal obstruction, or hypertriglyceridemia.

Chronic pancreatitis

Long-standing inflammatory lesions of the pancreas leading to persistent pain or pancreatic dysfunction such as diabetes, malabsorption, and weight loss.

Hypertriglyceridemia

Elevated serum triglycerides; acts as a predisposing factor for acute pancreatitis in the U.S.

Pancreatic cancer

Highly fatal malignancy accounting for ~2% of cancers but 4th in cancer deaths; median survival ~12 months.

Hypocalcemia (in pancreatitis)

Potentially severe drop in serum calcium during acute necrotizing pancreatitis requiring calcium replacement.

Acute respiratory distress syndrome (ARDS)

Serious pulmonary complication and leading cause of death in severe pancreatitis alongside renal failure and intra-abdominal sepsis.