The Gallbladder and Biliary Ducts
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The liver | Main Anatomy Index | The
Last updated 30 March 2006
- This is a piriform (pear-shaped) sac that lies along
the right edge of the quadrate lobe of the liver.
- It sits in a shallow depression on its visceral
surface, called the gallbladder fossa.
- It hangs inferiorly like a pear with the cystic duct
representing its stalk.
- Its rounded fundus usually projects below the
inferior border of the liver.
- It is normally covered on its posterior and inferior surfaces by peritoneum.
- Occasionally, it may be completely invested in peritoneum and may even be connected to
the liver a short mesentery.
- The gallbladder stores and concentrates
bile secreted by the liver.
- It can usually store between 30-60 mL of bile.
- For the purposes of description it is divided into a fundus,
body and neck.
The Fundus of the
- It is its wide end that projects from the inferior border of the liver.
- It is usually located at the tip of the 9th costal
cartilage in the midclavicular line.
- This is where the linea semilunaris marks the lateral
edge of the rectus abdominis and meets
the costal margin.
The Body of the Gallbladder
- Its main part is directed superiorly, posteriorly, and to the left
from the fundus.
- It lies in contact with the visceral
surface of the liver, to which it is attached by loose connective tissue.
The Neck of the Gallbladder
- It is narrow, tapered,
and directed toward the porta
- It makes an S-shaped bend and is somewhat constricted
as it becomes continuous with the cystic
- The neck is twisted in such a way that its mucosa is thrown into a spiral
fold (valve of Heister).
- The neck serves as a guide to the omental (epiploic) foramen, which lies to its immediate left,
posterior to the free margin
of the lesser omentum.
The Cystic Duct
- The duct of the gallbladder is 2-4 cm long.
- At first it runs superiorly and to the left from the gallbladder.
- It then turns posteriorly and finally inferiorly to join the common hepatic
duct to form the bile duct.
- The cystic duct runs between the layers of the lesser
omentum, usually parallel to the hepatic duct, before
joining it near the porta hepatis.
- The mucous membrane of the cystic duct is thrown into a spiral
fold with a core of smooth muscle.
- This fold is continuous with the spiral fold of the neck
of the gallbladder.
- As it coils along the cystic duct, it has the appearance of a spiral
- The spiral fold keeps the cystic duct constantly open
- Bile can easily pass into the gallbladder
when the bile duct is closed by the choledochal sphincter
and/or the hepatopancreatic sphincter.
- Bile can pass the opposite direction, into the duodenum, when the gallbladder contracts.
A hormonal mechanism (cholecystokinin) is involved in
Supply of the Gallbladder and Cystic Duct
- The gallbladder is supplied by the cystic artery, which
commonly arises from the right hepatic artery, in the
angle between the common hepatic artery and
the cystic duct.
Drainage of the Gallbladder and Cystic Duct
- Cystic veins join the right
branch of the portal vein.
- The veins of the fundus and body of the gallbladder pass
directly into the liver.
Drainage of the Gallbladder and Cystic Duct
- Most lymph passes to the hepatic lymph nodes, often via
the cystic lymph node, near the neck of the gallbladder.
- Efferent vessels from these lymph nodes pass to the coeliac lymph
of the Gallbladder and Cystic Duct
- The nerves pass along the cystic artery from the coeliac plexus (sympathetic), the vagus
nerve (parasympathetic) and the right phrenic nerve
- The hepatic plexus also issues an offshoot
to the cystic artery.
The Biliary Ducts
- Bile is secreted by the hepatocytes into bile canaliculi, the smallest branches of the intrahepatic duct system.
- Most of the canaliculi drain into small interlobular bile ducts,
which joint with others to form progressively larger ducts.
- Eventually, right and left
hepatic ducts are formed that emerge from the porta
- The right hepatic duct drains the right lobe of the liver and the left, the left lobe.
- Shortly after leaving the porta hepatis, the right and
left portal ducts unite to form the common
- About 4 cm in length, it passes
inferiorly and to the right, between the
layers of the lesser omentum.
The Bile Duct
- The common hepatic duct is joined on the right side at
an acute angle by the cystic duct
from the gallbladder to form the bile duct (common bile
- This large duct is 8 to 10 cm long and 5 to 6 mm in diameter.
- It runs in the free edge of the lesser omentum with the hepatic artery and portal
- It passes inferiorly, anterior
to the omental foramen, where it is anterior
to the right edge of the portal vein and on
the right side of the hepatic
- As it passes posterior to the pancreas,
occupying a groove in the posterior part of the head or embedded
- As it runs posterior to the duodenum,
the bile duct lies to the right of the gastroduodenal
- On the left side of the descending part of the duodenum, the bile
duct comes into contact with main pancreatic
- The two of them usually run obliquely through the wall
of the duodenum, where they usually unite to form the hepatopancreatic ampulla.
- The distal constricted part of the ampulla opens into the descending part of the
duodenum, at the summit of the major duodenal papilla, 8 to 10 cm from the pylorus.
- The circular muscle around the distal end of the bile
duct is thickened to form the choledochal sphincter (G. choledochus,
- This is a muscular sheath that surrounds the bile duct just before it penetrates the
- There is also a sphincter around the hepatopancreatic ampulla,
the hepatopancreatic sphincter.
- This sphincter controls both the discharges of bile and pancreatic juice into the
Arterial Supply of the
- The bile duct is supplied by several arteries:
- The distal or retroduodenal part
is supplied by the posterior superior pancreaticoduodenal artery;
- The middle part is supplied by the right
- The proximal part is supplied by the cystic
Venous Drainage of the
- The veins from the proximal part of the bile duct and
the hepatic ducts generally enter the liver directly.
- The posterior superior pancreaticoduodenal vein drains
the distal part of the bile duct, and empties into the portal vein
or one of its tributaries.
Lymphatic Drainage of
the Bile Duct
- Lymph passes to the cystic lymph node near the neck of
the gallbladder, the nodes of the omental foramen, and the hepatic
- Efferent lymph vessels pass to the coeliac nodes.