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Gall Bladder
• Pear-shaped sac (L 7-10, B 2.5 , capacity 30-50ml)
•…
Gall Bladder
• Pear-shaped sac (L 7-10, B 2.5 , capacity 30-50ml)
• Location: Undersurface right lobe of the liver (GB fossa)
• Extent: Right end of porta hepatis to liver inferior border
Parts :
• Fundus: directed downward, forward, and to the right
• Neck: narrow and tapered; directed toward the porta hepatis; makes an S-shaped bend and joins cystic duct
• Body: directed upward, backward, and to the left
• Relations
• Anterior: anterior abdominal wall (at the level of the tip of 9th rt CC ninth right costal cartilage)+ liver
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• Peritoneum completely surrounds the fundus of the gallbladder and binds the body and neck to the visceral surface of the liver (or complete with mesentry)
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Clinical Problems Mobile GB Gallstones Biliary Colic Acute Cholecystitis Cholecystectomy and the Arterial
Supply to the Gallbladder Gangrene of the Gallbladder Referred pain
• Blood Supply:
• Cystic artery (variable),common from right hepatic artery
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Cystic duct
• L: 3-4 cm • Connects neck of GB to CHD • Passes between the layers of the lesser omentum, usually parallel to the common hepatic duct, which it joins at acute angle to form the bile duct.
• The mucosa of the neck spirals into the spiral fold (spiral valve)
• The spiral fold functions:
• Keep the cystic duct open (forward and backward)
• It offers additional resistance to sudden dumping of bile when the sphincters are closed, and intra-abdominal pressure is suddenly increased, as during a sneeze or cough
Common Bile Duct (CBD)
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• Course:
- Infradudenal part: runs in a groove near right border of posterior surface of head of pancreas (B.S Posterior superior pancreaticoduodenal artery and gastroduodenal artery)
- Supraduodenal part: right border of the lesser omentum (B.S : cystic artery )
- Retrodudenal part: behind 1st part of duodenum in front of the portal vein, and to the right of the hepatic artery ( B.S Right hepatic artery)
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