important points of Gall bladder Anatomy

1. 1
Nangarhar University Teaching Hospital
General Surgery Word
Anatomy & physiology of
Gall Bladder and biliary tree
Prepared by : Dr Abdullah ihsaas
General Surgery Trainee Specialist

2. Introduction
• Component of extrahepatic biliary system
along with
• Rt. and Lt.hepatic ducts
• Common hepatic duct
• Cystic duct
• Common bile duct

3. Gall bladder
• Dilated part of extra
hepatic system
• Pear shaped
• 7,5-12cm long
• 3cm broad.
• 35-50 ml capacity.
• When
Obstructed
300ml.

4. Anatomical Parts
• Fundus
• Body
• Infundibulum
• neck

5. Wall of Gallbladder  smooth muscle and Fibrose
tissue
Epithelial membrane  Columnar epithel which
has luschka crypts

6. Biliary tree
• Right and left hepatic ducts
• Common hepatic duct-2,5 cm, runs downwards and is
joined by cystic duct (2,5 cm) to form Common Bile
Duct.
• Accessory hepatic ducts present in about 5% of
subjects.
• Usually come from right lobe of liver.and terminate
either in gall bladder or CHD.

7. Cystic duct
• 2,5 cm long
• Cystic duct forms a series of crescentic
folds arranged spirally-spiral valve of
Heister.

8. Common bile duct
7,5 cm long.
It has four parts:
1. Supra duodenal portion 2,5 cm longest At free border of Lesser .Omentom
2. Retro duodenal portion
3. Infra duodenal portion Positioned at sulcus
4. Intra duodenal portion At 2nd part of duodenum and has oddi sphincter
Distal constricted end of ampulla opens at the summit of major duodenal
papilla (8- 10cm distal to pylorus.)

9. Calot’s triangle

11. Venous drainage
• Superior surface of GB drains into hepatic veins.
• Rest of GB is  drained by cystic veins  R.B of
portal vein.
• Lower part of bile duct Drains into portal vein.
Blood supply of Gallbladder
Cystic artery  branch of R Hepatic Artery
Additional cystic artery  branch of Gastro duodenal
artery

13. .

14. Lymphatic drainage
• Cystic lymph node of Lund and node of
anterior border of epiploic foramen
• Upper pancreaticosplenic nodes.

15. Nerve supply
• Cystic plexus of nerves
• Right and left vagus nerves
• Right phrenic nerve
• Pain from GB may be referred to stomach,
inferior angle of right scapula, right
shoulder.

16. Surgical physiology of Gallbladder
Functions
 Gall bladder
 It stores Bile
 It concentrates bile
 Ejects bile into lumen
 Bile
 Emulsify dietary lipids
 Formation of micelles with products of lipid digestion.