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The Gall Bladder

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					The Gallbladder
                   Facts

• Pear-shaped storage tank

• Located right side of the liver

• Concentrates and stores bile from the liver
             What is bile?
• Contains cholesterol, bile acids and
  several bile pigments
• One bile pigment bilirubin (produced from
  breakdown of hemoglobin)
• Bacteria in the colon break down bilirubin
  into a variety of pigments that give feces
  a brownish color
             Bile Functions

• Aids in fat emulsification (bile breaks apart
  large fat globules so that enzymes from
  the pancreas can digest fats)

• Helps body absorb lipid-soluable vitamins
              Bile Pathway
• Food enters stomach
• Duodenum releases cholesytokinin
• Causes the gallbladder to contract and
  Sphincter of Oddi to relax
• Letting bile stored in the gallbladder flow
  into the duodenum
           Bile Obstruction
• Bile no longer carried to the duodenum
• Absorbed by the blood
• Gives skin/tissues a yellow color
  (jaundice)
• Bile pigments excreted from the blood by
  kidneys gives urine a dark color
• Feces no longer colored with bile pigment
  are gray like putty or clayed colored
           Anatomical Terms
•   Chole – pertaining to bile
•   Cholecyst – pertaining to gallbladder
•   Cholang – pertaining to bile ducts
•   Choledocho – pertaining to the common
    duct
                  Calculi
• Cholelith – gallstone

• Cholelithiasis – presence of gallstones

• Choledocholithiasis – stone in the
  common bile duct
              Inflammation
• Cholecystitis – inflammation of the gall
  bladder

• Cholangitis – inflammation of a bile duct
• Calculous cholecystitis – inflammation of
  the gallbladder due to gallstones

• Acalculous cholecystitis – gallbladder
  inflammation without gallstones
                Gallstones
• Caused by changes in the composition of
  bile
• Gallbladder normally secretes mucous
  and proteins that promote cholesterol
  crystal formation
• Impaired gallbladder motility, biliary stasis,
  and changes in bile content lead to stones
          Types of Stones
• Yellow-green
• Black
• Brown
   Symptoms of Cholecystitis
• Steady pain RUQ or epigastrium
• May radiate to right scapular region or
  back
• RUQ tenderness and abdominal guarding
• Nausea and vomiting
• Fever
              Procedures
• Cholangiography – x-ray of bile ducts

• Cholecystography – x-ray of gall bladder

• Ultrasound of the Gallbladder
       Surgical Interventions
• Cholecystostomy – incision and drainage
  of gallbladder

• Choledochostomy – exploration of the
  common bile duct

• Cholecystectomy – removal of gallbladder
       Surgical Intervention
• Laparoscopic cholecystectomy

• Open cholecystectomy
          The Challenge


• Choledochoduodenostomy
               Answer
• Anastomosis of common duct to
  duodenum

				
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posted:10/14/2012
language:English
pages:19