This is a detailed slides about the gall bladder anatomy which helps better understanding of this intraperitoneal organ. I made those slides during my GS rotation under the supervision of the chief of surgery departments at King Fahd Speciality hospital - Dammam

1. GALL BLADDER
ANATOMY
Nasser Saad Alalyani
ENT Resident

2. GALL BLADDER
• The gallbladder is a gastrointestinal
organ located within the right
hypochondrial region of the abdomen.
• This intraperitoneal, pear-shaped sac
lies within a fossa formed between the
inferior aspects of the right and
quadrate lobes of the liver.
• The primary function of the gallbladder
is to concentrate and store bile which is
produced by the liver.

3. GROSS
ANATOMY
The gallbladder is a pear-
shaped sac, about 7 to 10 cm
long.
located in the inferior surface
of the liver .
Average capacity of 30 to 50
mL.
The gallbladder is divided into
four anatomic areas: the
fundus, the corpus (body), the
infundibulum”Hartsmann’s
pouch”, and the neck.

4. MICROSCOPICALY
The gallbladder is lined by a single tall
columnar epithelium that contains
cholesterol and fat globules.
The mucus secreted into the gallbladder
originates from mucosa lining the
infundibulum and neck of the gallbladder,
but are absent from the body and fundus
The epithelial lining of the gallbladder is
supported by a lamina propria.
The muscle layer has circular longitudinal
and oblique fibers,. The perimuscular
subserosa contains connective tissue,
nerves, vessels, lymphatics, and adipocytes
It is covered by the serosa except where
the gallbladder is embedded in the liver.

5. BLOOD SUPPLY
Cystic artery:
 supplies the gallbladder , is usually a branch
of
the right hepatic artery (>90% of the time).
 Found in “triangle of Calot”
When it reaches the neck of the gall bladder,
it divides into anterior and posterior divisions.
• Venous return:
 Either:
 Through small veins that enter
directly into the liver or,
 Rarely, to a large cystic vein that
carries blood back to the portal vein.

6. Lymph from the gallbladder drains into the cystic
lymph nodes, situated at the gallbladder neck.
The cystic nodes then empty into the hepatic
lymph nodes, and ultimately, the coeliac lymph
nodes.
LYMPHATIC
DRAINAGE

7. NERVE SUPPLY
The gallbladder receives parasympathetic, sympathetic
and sensory innervation.
 Sympathetic and sensory fibers:
Celiac plexus
 Parasympathetic:
Vagus nerve
contraction of the gallbladder, and the secretion of bile into the
cystic duct due to relaxation of the sphincter of Oddi.
 The majority of this response however, is mediated by
circulating cholecystokinin.

8. ANOMALIES
classic description of the gall bladder and its
blood supplies applies only in about 1/3 of
patients.
Location
 intrahepatic
 retrohepatic
 retroperitoneal
 left-sided: extremely rare (<0.20%)
Morphology:
Phrygian cap : folding of the fundus back upon the
gallbladder body.
Hartmann pouch Dilatation (infundibulum),
usually pathological (Cholelithiasis)

9. CONT.
 Number:
Gall bladder Duplication
Most common variants:
1. each gallbladder has its own cystic duct that
empties independently into the same or different
parts of the extrahepatic biliary tree,
2. and as two cystic ducts that merge before they
enter the common bile duct
Gall bladder Agenesis(Rare)
Duct of Luschka
drain directly from the liver into the body of the
gallbladder.
Risk of Biloma after cholecystectomy

10. CONT.
 Cystic artery
 Common
 The cystic artery arises from the
right hepatic artery in about 90% of
cases, but may arise from the left
hepatic, common hepatic,
gastroduodenal, or superior
mesenteric arteries

11. GALL
BLADDER IN
IMAGING
USG

12. GALL
BLADDER IN
IMAGING
CT

13. GALL
BLADDER IN
IMAGING
MRI

14. REFRENCES
 Schwartzs Principles of Surgery , 10th Edition.
 Mont Reid Surgical Handbook, The, 6th Edition.
 the washington manual of surgery 6th edition.
 Radiopaedia.org

15. THANK YOU