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Gall bladder & bile ducts

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  • Biliary tract includes gallbladder and bile ducts

  • Within the liver, small biliary channels known as bile ductules join together to form the smaller bile ducts, which ultimately form right and left hepatic ducts, exit the liver, which in turn join to form common hepatic duct (CHD) 

  • Gall bladder is a pear shaped organ, situated below the liver

  • Bile secreted from the liver flows through the bile ducts 

  • Cystic duct of the gallbladder joins the common hepatic duct to form common bile duct (CBD)

  • CBD joins the main pancreatic duct (MPD) at the lower end and the common channel enters into the 2nd part of duodenum

  • Gall Bladder concentrates the bile and releases during food ingestion 

  • Bile and pancreatic juices are released into the duodenum at the time of meal, which helps in digestion and absorption of food nutrients especially fat and fat soluble vitamins

What are the common biliary disorders?

  • Gall bladder stones (Cholelithiasis)

  • CBD stones (Choledocholithiasis)

  • Cholangitis

  • Choledochal cyst (CDC)

  • Bile duct strictures

    • Post cholecystectomy, PSC etc.

  • Tumors

    • Gall bladder polyps

    • Gall bladder cancer

    • Cholangiocarcinoma ( hilar, distal, intrahepatic) etc.

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What are the common symptoms of biliary disorders?

  • Pain in right upper abdomen

  • Lump in right upper abdomen

  • Fever

  • Jaundice 

  • Generalised itching etc.

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What are the commonly done  tests for Biliary disorders?

  • Blood test - LFT ( Bilirubin, albumin, AST, ALT, ALP, GGT) , PT/INR

  • Imaging -

    • Ultrasonography

    • CT scan

    • MRI scan

    • PET scan etc. 

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What are the commonly done biliary procedures/surgeries?

  • For gall Bladder stones - Laparoscopic cholecystectomy

  • ​For CBD stones
    • ERCP & stone removal +/- CBD stenting
    • Surgery
  • For bile duct strictures​
    • ERC dilatation +/- CBD stenting
    • Biliary-enteric anastomosis - RYHJ (hepatico-jejunostomy), CDD (choledocho-duodenostomy) etc.
  • For Tumors

    • Whipple's procedure

    • Radical cholecystectomy etc

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Discussion 

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Clinic Address: Mysore

Impulse Medical Center, Near Vidyashrama College, Temple Road, Mysore-570012 

Clinic Address: Mandya

Sattva Health Care, Behind TVS show room, 100 feet Raod, Mandya -571401 

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