Biliary system

Bile

is manufactured by the liver, transported

by various ducts and stored in the gallbladder.

Liver

• Largest solid organ in the body.

• Occupies most of the RUQ.

• Weighs 3-4 lbs (1.5 kg)

⚬ Right lobe

⚬ Left lobe

⚬ Quadrate lobe

⚬ Caudate lobe

Lobes of the liver, divides into two major and two minor lobes:

• Store bile

• Concentrate bile

• To contract when stimulated

Functions of the gallbladder:

Common bile duct

• Approximately 7.5cm in length.

• Enters in the second or descending

portion of the duodenum

Chole-

Prefix denoting relationship to bile

Cysto-

Prefix denoting sac or bladder

Cholangiogram

Radiographic examination of the biliary ducts

Cholecystocholangiogram

Study of both the gallbladder and the biliary ducts

Choleliths

Galstones

Cholelithiasis

Condition of having gallstones

Cholecystitis

inflammation of the gallbladder

Cholecystectomy

surgical removal of the gallbladder

Choledocholithiasis

• Presence of stones in the biliary ducts

• May form in biliary ducts or migrate from

gallbladder.

Cholelithiasis

Presence of abnormal calcifications or stones in the GB

Acute cholecystitis

Inflammation of the gallbladder

mostly due to a stone lodged in the

neck of the gallbladde

Chronic cholecystitis

• Inflammation of the gallbladder due to

gallstones but may also be an

outcome of pancreatitis or carcinoma

of the gallbladde

Neoplasms

"New growths" which may be benign or

malignant.

Biliary stenosis

Narrowing of one of the biliary

ducts

Cholecystitis and jaundice

... and ... may result from biliary stenosis

Oral cholecystogram

• Radiographic examination of the GB

by oral administration of CM

• Patient is made to swallow special

iodine pills the night before.Your

body absorbs the dye and sends it

to the gallbladder so doctors can

see stones, swelling, or how well the

organ works

Sonography

... replaced oral cholecystogram

Medical sonography

Noninvasive means of studying

the GB and biliary ducts

⚬ No ionizing radiation

⚬ Detection of small calculi

⚬ No contrast medium

⚬ Less patient preparation

Medical sonography offers four advantages over OCG:

Percutaneous transhepatic cholangiography

• Preoperative radiologic examination of the

biliary ducts

• Performed on patients with jaundice when the

ductal system is dilated as seen in CT or

Sonography but the cause of obstruction is

unclear

Postoperative (T-tube) cholangiography

Radiologic examination of the biliary tract

using a T-shaped or pigtail-shaped catheter

left in the common hepatic and common bile

duct.

Postoperative (T-tube) cholangiography

Performed to show the caliber and patency of

the ducts, status of the sphincter of the

hepatopancreatic ampulla, and the presence

of residual or previously undetected stones or

other pathologic conditions.

Endoscopic retrograde cholangiopancreatography (ERCP)

• Procedure used to

diagnose biliary and

pancreatic pathologic

conditions.

• It is also done to remove

stones in biliary ducts and

open narrowed or blocked

ducts.