gallbladder, only in appearance it seems to be an inconspicuous organ. If you look at it, it plays an important role in the functioning of the entire system. gastrointestinal tract.

All this suggests that thanks to it a person feels good and does not face health problems.

To date, it has been possible to almost thoroughly study anatomical structure human body.

Modern technologies make it possible to treat pathologies, even if they do not have external manifestations or clear clinical symptoms.

It is important to be attentive to the body’s signals and consult a doctor on time.

About the gallbladder

It should be noted that the gallbladder is one of the elements of the gastrointestinal tract. Its function is to accumulate bile, which comes from the liver.

The gallbladder is located in the hypochondrium on the right side. More precisely, this is the lower edge of the rib on the right side.

In fact, the structure of an organ indicates what its main functions are. Human anatomy confirms the fact that the gallbladder is very similar to a pear in appearance.

It turns out that it’s not for nothing that experts divide it into several parts. One of them was called “bottom”. The thing is that this is often the widest organ. The middle one is called the “body”, but the narrow one is called the “neck”.

Looking at the pictures showing the gallbladder, you can better understand why the departments were given such names. The gallbladder canal extends from the cervix; it is called the cystic duct. It is connected to the hepatic, and there is a small distance between them.

In accordance with the size of the organ, it should be noted that the length of the gallbladder can vary from 5 to 14 cm.

Its volumes are considerable, the indicators vary from 30 to 80 ml. This amount of secretory fluid may remain in the organ.

Functions of bile

In fact, not everyone wonders what role the gallbladder plays in the gastrointestinal tract. You need to understand that the liquid accumulated in it is very important.

It is able to launch important enzymes that improve digestion. The process takes place in the intestinal area.

Thanks to bile, it is possible to break down fats. The liver releases bile, it passes into the bladder, and from there into the area of ​​the duodenum.

About 1.5 liters of secretory fluid can pass through the gallbladder per day. It turns out that the organ is really important, and therefore it is incredibly difficult for the gastrointestinal tract to do without it.

Knowing what the gallbladder looks like and what its real tasks are in the digestive tract, it is also important to understand what causes diseases of the organ.

Pathologies of the gallbladder and tract

Today, deviations in the gallbladder area are quite common in people.

Sad statistics also confirm the fact that not all people understand what is really happening to them.

It cannot be otherwise, because some people don’t even know where the organ is located, what are the signs of its deviation from the normal state. If only for this reason, it is worth reading this article to the end.

If there are disruptions in the functions of the gallbladder, a person may develop an allergy.

No exception is eczema, pancreatitis and diabetes. These pathologies can be caused by an irregular shape of the gallbladder.

When a person turns to a doctor for help, he will prescribe an ultrasound examination. There is no need to worry, the procedure is completely painless.

The ultrasound specialist will examine the organ, establishing how the gallbladder works, its location in accordance with other organs, and will understand whether there is any pathology.

Preparing for an ultrasound

To undergo an ultrasound examination of the gallbladder, the patient needs to know some stages of preparation, so that in the future there will be no problems with diagnosing the condition of the organ and false results of the study.

The preparation methods are very simple, and therefore there will be no problems with this. Before the procedure, it is better not to eat anything for 12 hours.

The doctor, on the contrary, may ask the patient to bring a number of foods for examination, which, if eaten, will cause contraction of the organ. As a rule, this is high-fat sour cream.

Determination of pathologies on ultrasound

Cholecystitis has become the most frequently diagnosed disease on ultrasound when examining the gallbladder.

A serious inflammatory process begins in the body, which triggers an increase in the thickness of the walls of the gallbladder.

Ultrasound allows you to determine this deviation from the norm. If this is an acute phase of the disease, its signs will manifest itself in the form of fever, attacks of vomiting and nausea, and weakness.

Inflammation can be characterized by pain in the right hypochondrium, which manifests itself after eating fatty foods.

Quite often this pathology develops into a more serious one, becoming chronic. This brings a person enough problems in the future.

It is for this reason that you should pay attention to all signals about problems in the body, and not neglect them, hoping that they will pass on their own.

An equally common occurrence is gallstone pathology. The phenomenon is indeed quite common. It can be detected through an ultrasound examination.

Those stones that are inside the gallbladder disrupt the functioning of the gastrointestinal tract when they block the organ channel.

Thanks to modern methods diagnostics, the doctor will be able to understand what stones are in the human body and how many there actually are.

Another advantage of hardware ultrasound examination is that pathology can be determined at an early stage of its development.

It just needs to be noted that a specialist should decipher the study. Only in this case can one expect that the treatment course will be chosen correctly, and therefore the pathology will soon be eliminated.

You cannot self-medicate; the outcome can be extremely unpleasant.

Anatomy of the liver and gallbladder

The location of the liver and gallbladder indicates that the organs are closely interconnected. The liver is located under the diaphragm.

Doctors consider the lobule, which consists of hepatocytes, to be the main unit of organ structure. All passages emerging from it are bile ducts.

They drain secretory fluid into the left and right bile ducts. As a result, both parts form a single duct. Thus, a system of interaction between the biliary tract and the liver is formed.

Treatment course

Having dealt with the issue of the structure of the gallbladder, adjacent organs, as well as the symptoms of pathologies, it is necessary to note what the treatment will be.

In this case, doctors adhere to general recommendations. They relate to debugging proper nutrition.

You need to follow a diet called “Table 5”. It is really strict, especially for those people who are used to eating fast food, fried and fatty foods.

You need to switch your attention to river fish, lean meat and poultry. It is recommended to eat more vegetables and fruits, dairy products.

It is best to use a double boiler or multicooker for cooking. Doctors consider stewing or boiling to be the optimal methods.

It is not forbidden to eat egg white omelettes, vegetable soups, cereals, and dried bread. But it is better to avoid sour vegetables and generally products with similar properties.

The thing is that acid irritates the mucous membrane of the organ, negatively affecting its condition. This increases pain in humans.

If you follow a dietary diet, the patient will feel relief. You need to make sure that the food you eat is not very cold or hot.

The same applies to drinks. The mode must be debugged. The fractional principle of nutrition will help with this, when a person eats in small portions 5-6 times a day. Getting used to this method of consumption is not so difficult.

Official medicine

There are other ways therapeutic treatment. They help restore the functional characteristics of the organ, eliminating signs of pathologies and eliminating inflammation.

Chinese healing methods

Here it would be appropriate to note the fact that not all patients like treatment using the methods of official medicine.

There are also those representatives who prefer to be treated in unconventional ways. A similar solution is often found in eastern countries.

Alternative medicine methods for treating the gallbladder are being cultivated in China. They are based on the teachings of meridians.

In accordance with the existing theory, a meridian should be understood as a channel that allows vital energy to make its way through the human body. This energy is called “Qi”.

In such situations, representatives of this movement select special treatment methods. We must admit that finding a good specialist in our country is not easy. This requires a lot of time and a lot of financial resources.

Folk recipes

But there are other areas of therapeutic therapy, which include folk recipes. They are also known for their effectiveness and have more than once helped to alleviate the situation of a sick person faced with gallbladder pathology.

To eliminate gallstone pathology, you can eat fresh strawberries. Servings should be 3 glasses per day. The course of therapy is 21 days.

If you can’t buy strawberries, you can help the patient by taking beetroot decoction. The recipe is not complicated. You need to take the vegetable tubers, wash them and, unpeeled, put them on the stove to cook.

They must be on fire for 6 hours. The liquid will thicken. This will be a healing panacea.

You need to drink 1/5 of a glass a day before meals. The reception is designed for every day for 15 days.

But it is important to consult with a specialist; beets have the ability to lower blood pressure, which in turn can lead to trouble.

Manifestation of gallbladder pain

In fact, one of the most serious signs of gallbladder malfunction should be called pain in the organ.

This symptom should be a reason to visit a doctor. You should contact a gastroenterologist or a therapist who will write a referral to see a specialist.

Many people wonder what pain in the gallbladder area is like. First, you need to note that it is important to know where the organ is located.

These are the right costal arches, the area where the liver is located. These organs, as mentioned above, have a tight relationship.

Those. The gallbladder is located in the lower part of the liver on the right side. If pain occurs in this area, this may indicate biliary colic.

In accordance with practical experience, it was found that pain can be felt not only in this area, but also in the area between the shoulder blades or in the area of ​​the right shoulder.

Clarifying the nature of pain during colic, it should be noted that it manifests itself in the form of attacks. It starts suddenly, maybe even late at night.

It is provoked by eating heavy food or alcohol. Over the course of an hour, pain may intensify, and sometimes even reach its maximum peak.

As a rule, the duration can reach up to 6 hours. Subsequently, it is difficult for a person to understand exactly where it hurts, because the discomfort moves to the navel and other areas, gradually spreading more and more.

There is no need to endure the sensations; you should immediately seek help from a doctor. Pathology can develop into serious consequences. One of them is gallbladder cancer.

Even if the phenomenon is rare, it is still better to undergo a full examination by a doctor to eliminate the risks of disease.

Useful video

Functions of the gallbladder

Dyskinesia of the gallbladder

Cholecystitis

Cholelithiasis

Gallbladder cancer

How to cure a gallbladder

The gallbladder is an organ that stores bile coming from the liver. It is located in the right longitudinal groove and has a characteristic green color. The liver is the size of a chicken egg. Several times a day, bile is secreted into the duodenum and is directly involved in the digestive process. Anatomically, the gallbladder is a continuation of the liver. Therefore, any diseases of one of the organs in one way or another negatively affect the condition of the other.

Features of the structure of the gallbladder

The external gallbladder resembles a sac-like oval formation of an elongated shape with one wide end and the other narrow end. The width of the organ decreases from the bottom to the neck, where the cystic bile duct begins to pass. At the porta hepatis, it enters the hepatic duct, and together with it forms the common bile duct, which unites with the pancreatic duct. It passes through the sphincter of Oddi into the duodenum.

The length of the gallbladder in adults reaches 8-10 cm. The width of the walls of the organ is 3-5 cm, but it can change due to stagnation of bile, overstretching of the walls with stones and the action of a chronic inflammatory process.

Functions of the gallbladder

Main functions of the gallbladder:

• accumulation and concentration of bile;
• participation in the digestive process;
• protection of the gastrointestinal tract from infectious pathogens;
• timely entry of the required amount of bile into the duodenum.

The liver constantly secretes bile and it is stored in the gallbladder. When food enters the stomach, complex biochemical processes are launched. The gallbladder contracts and releases a portion of bile into the duodenum, where it begins to directly participate in the digestive process. With increased fat content of foods, the organ begins to contract more intensely in order to secrete more secretions.

Bile contains special pigments, acids, phospholipids, trace elements and substances with antimicrobial activity. It is the protective function of the gallbladder that prevents the occurrence of infectious and inflammatory processes in other organs of the digestive system.

Causes of gallbladder diseases

The gallbladder is constantly influenced by external and internal factors, including the nature of a person’s diet, stress, concomitant diseases, level physical activity. And for a long time a person may not be aware of the pathology. main reason development of most gallbladder diseases - the formation of stones.

Stones cause an inflammatory process, provoke stagnation of bile, proliferation of infectious pathogens, blockage of ducts, development dangerous diseases, which also require surgical treatment.

Factors that provoke dysfunction of the gallbladder and the development of diseases:

Gallbladder diseases are characterized by a long asymptomatic course. And only years later can they appear characteristic features, which indicate stagnation of bile and blockage of the bile ducts with stones.

Symptoms of gallbladder dysfunction

The main symptom of gallbladder disease is acute or dull aching pain in the right hypochondrium. It occurs with calculous cholecystitis, and with non-calculous cholecystitis, and with the formation of cysts and tumors. Depending on intensity pain syndrome a person decides whether to turn to professionals for help or not. But there is no need to wait for signs of acute biliary colic, which can result in serious complications, including perforation of the bladder walls. As soon as pain appears in the right hypochondrium, make an appointment with a gastroenterologist or therapist and undergo a series of laboratory and instrumental tests.

Additional symptoms of gallbladder disease:

• nausea and vomiting;
• belching with bitterness;
• disturbance of stool, but more often - diarrhea, discoloration of stool;
• bloating;
• darkening of urine;
• small rashes on the body.

Signs of biliary colic

Many people are not even aware of the presence of stones until symptoms of biliary colic appear. A person develops sharp pain in the right hypochondrium and epigastrium, which can extend under the scapula, into the neck and lower back. Fatty or spicy foods and alcohol consumption provoke attacks.

In some people, biliary colic develops after excessive physical exertion and severe stress. If a stone gets stuck in the bile duct, obstructive jaundice appears, the stool becomes discolored, and the urine darkens.

Common gallbladder diseases

There are many diseases of the gallbladder, but the most common are the following:

• gallbladder dyskinesia;
• cholecystitis;
• cholelithiasis;
• gallbladder cancer.

Dyskinesia of the gallbladder

With dyskinesia of the gallbladder, the contractility of the organ is impaired and the outflow of bile worsens. The disease progresses more often in women. Primary dyskinesia occurs with a congenital disorder of the motor activity of the gallbladder and a decrease in the sensitivity of its cells to hormonal mediators. Secondary dyskinesia is the result of hormonal treatment, the development of concomitant diseases and pathology of the biliary tract, including cholelithiasis and cholecystitis.

Most often the disease develops due to high pressure in the biliary tract in combination with reduced activity of the bladder walls. In this case, the organ does not empty on time, bile enters the duodenum in limited quantities, which provokes chronic digestive disorders.

The main symptoms of gallbladder dyskinesia:

• constant Blunt pain in the area of ​​the right hypochondrium, not associated with food intake;
• pain increases with changes in body position, when intra-abdominal pressure increases and bile outflow worsens;
• nausea and vomiting;
• slight discoloration of the skin yellow;
• a feeling of bitterness in the mouth;
• increased sweating;
• the appearance of rich colored urine.

To treat gallbladder dyskinesia, prokinetics, antispasmodics, and nonsteroidal anti-inflammatory drugs are used. It is possible to prescribe bile-containing drugs. The main emphasis is on diet. It is worth limiting foods that excessively contract the gallbladder: fats, fried, smoked and spicy foods, alcohol. Additionally, it is recommended to normalize weight and avoid excessive physical activity.

Cholecystitis

Cholecystitis is an inflammation of the gallbladder, which most often occurs against the background of the formation of stones. The disease occurs in middle-aged and elderly people, mainly in women.

Violation of the outflow of bile is provoked by diseases such as cholelithiasis, biliary dyskinesia, congenital or acquired anomalies of the gallbladder. Predispose to the development of cholecystitis is a violation of the diet, frequent alcohol consumption, a sedentary lifestyle, and large gaps between meals.

The main symptoms of the inflammatory process in the gallbladder:

• paroxysmal pain in the right hypochondrium and abdomen;
• weakness;
• increased sweating;
• nausea, vomiting mixed with bile;
• diarrhea;
• severe flatulence;
• feeling of bitterness in the mouth;
• chills, slight increase in body temperature;
• yellowness and itching of the skin.

Like other gallbladder diseases, cholecystitis requires diet. Nutrition should be as gentle as possible on the mucous membrane of the digestive tract. It is recommended to eat 5-6 times a day, but in small portions. Alcohol in any form, fatty meats and fish, smoked meats, seasonings, marinades, spices, sauces, mushrooms, and legumes are prohibited.

Drug therapy includes the prescription of painkillers and antispasmodics. If cholecystitis is infectious, antibiotics are prescribed. Additionally, experts recommend using drugs that stimulate bile formation (choleretics) or accelerate the outflow of bile (cholekinetics). But such remedies are prescribed only by a doctor who knows the nature of the disease and the condition of the gallbladder.

For the calculous form of cholecystitis, it is used surgical treatment- open or laparoscopic cholecystectomy.

Cholelithiasis

Gallstone disease is accompanied by the formation of stones in the gallbladder and ducts. The pathology is based on the deposition of pigments, proteins, and calcium salts as a result of lipid metabolism disorders and constant stagnation of bile.

The experience of specialists has shown that drug therapy for calculous cholecystitis and other complications of cholelithiasis is ineffective. The only correct decision is to perform the operation in a timely manner. Otherwise, dangerous complications may occur, including perforation of the gallbladder wall.

The main symptoms of cholelithiasis:

• acute cutting pain in the right hypochondrium, which appears after consuming prohibited foods and drinks;
• nausea and vomiting (occur reflexively in response to irritation of the peripapillary zone duodenum);
• traces of bile may be present in the vomit;
• increase in body temperature;
• when the sphincter of Oddi and the common bile duct are blocked, obstructive jaundice occurs, stool becomes discolored, and urine may darken.

Pain syndrome in gallstone disease occurs as a result of spasm of the muscles of the gallbladder and its ducts in response to the irritating effect of stones and overstretching of the walls of the organ. In case of exacerbation, a person needs immediate medical attention.

Drug treatment for gallstones is ineffective. It only allows you to slow down the development of the disease. Even after destruction of stones during shock wave lithotripsy or laparoscopy, the risk of their re-formation is very high. Therefore, experts recommend cholecystectomy before complications and severe disturbances in the functioning of the digestive system occur.

Watch this video about one of the common gallbladder diseases in which stones form.

Gallbladder cancer

Malignant tumors may appear in the gallbladder - adenocarcinoma or squamous cell neoplasms. They account for 5-10% of all cancerous diseases of the gastrointestinal tract. The tumor process is more often found in women over 50 years of age. In 80% of cases, specialists identify adenocarcinoma, which can grow in the fundus or neck of the gallbladder. Cancer often metastasizes to regional The lymph nodes, peritoneum, ovaries and liver.

The main cause of a malignant tumor of the gallbladder is a long course of cholelithiasis or chronic cholecystitis. Most often, the tumor develops in an organ clogged with stones. Stones constantly damage the mucous membrane of the gallbladder, provoking malignant tissue degeneration.

Main symptoms of gallbladder cancer:

• weakness;
• constant dull pain in the hypochondrium, which people with gallstone disease get used to ignoring;
• weight loss;
• subfebrile temperature;
• yellowing of the skin and mucous membranes;
• constant nausea, possible vomiting;
• pruritus;
• lightening of stool and darkening of urine.

For a long time, gallbladder cancer occurs without significant symptoms. Often the disease is discovered accidentally during histology during cholecystectomy or against the background of calculous cholecystitis.

When applying early medical care and open cholecystectomy, the prognosis of the disease is favorable. But in most cases the disease is detected at a late stage, when distant metastases are actively spreading and it is not possible to manage only with radical removal of the tumor.

How to cure a gallbladder

Treatment for the gallbladder is selected by a gastroenterologist or therapist based on laboratory and instrumental diagnostic data. In this case, the age of the patient is taken into account. As a rule, the basis of most gallbladder pathologies is a chronic inflammatory process against the background of cholelithiasis. Therefore, the main method of treatment is removal of stones or the affected organ.

At an intermediate stage, during preparation for surgery or when providing first aid to a person with symptoms of biliary colic, the following groups of drugs may be prescribed:

• antispasmodics, analgesics;
• anti-inflammatory drugs;
• choleretic agents, choleretics and cholekinetics;
• hepatoprotectors;
• multivitamin complexes;
• preparations with acids that can have a destructive effect on stones.

Treatment of the gallbladder necessarily includes adherence to a therapeutic diet (table No. 5). The number of exacerbations of the underlying disease per year largely depends on this. If your doctor recommends surgery, you should not refuse it. Specialists are aware of severe cases of complications, due to which people end up in intensive care, and the surgeon still has to urgently perform cholecystectomy.

Indications for surgical treatment

Gallstone disease and chronic cholecystitis are accompanied not only by the formation of stones, but also by an irreversible impairment of the functional abilities of the gallbladder. The organ ceases to perform its main job, and there is no point in preserving it, since impaired functions can trigger a chain of additional diseases of the gastrointestinal tract.

The main indication for cholecystectomy is the presence of stones. The operation can be carried out planned or emergency, be open (with dissection of the anterior abdominal wall) or laparoscopic (the surgeon removes the organ through 4 punctures). Laparoscopy of the gallbladder is preferable to laparotomy. The operation using microsurgical instruments and endoscopic equipment is easier to understand, and it does not require long-term recovery.

An emergency open cholecystectomy can be performed if there is a risk of developing dangerous complications, including peritonitis and the risk of perforation of the gallbladder walls.

Nutrition for gallbladder health

Gallbladder diseases are chronic. The process of bile secretion is influenced by the degree of fat content of foods and many other food features. With pathologies of the gallbladder, it is very harmful to eat rarely, taking long intervals between meals. In this case, the bile constantly stagnates, irritates the walls and creates conditions for the formation of stones.

It is recommended to eat at regular intervals, preferably at the same time. It is necessary to exclude all potentially dangerous and prohibited foods, alcohol, carbonated drinks, and sour juices from the diet. The diet should be especially strict during the period of exacerbation of the disease. On the first day after the development of biliary colic, it is forbidden to eat, and you can only drink a decoction of chamomile, rose hips or still mineral water.

Prevention of gallbladder diseases

Even if you don't have gallbladder disease, you can reduce your risk of developing it by following the principles healthy eating. Limit spicy, fatty, spicy foods, sauces and mayonnaise, and smoked foods. Do not consume fast food or alcohol, try to exercise regularly and lead an active lifestyle.

Prevention of the occurrence of gallbladder diseases necessarily includes preventive examinations of the organ, especially with unfavorable heredity. If among your close relatives there are people who suffer from cholecystitis or cholelithiasis, do not be lazy to undergo regular ultrasound diagnostics. And if stones are detected, agree to surgical treatment.

Watch conversations about the gallbladder with Professor Neumyvakin.

In the human body, the gallbladder has an interesting location. In the lower part of the liver there is a depression to which is attached a small elastic bladder woven from muscle fibers. Nature itself made sure that this organ, important for digestion, was protected as much as possible.

Functions of the gallbladder

Gallbladder: schematic placement

The gallbladder is closely related to the liver, because it is in the liver that bile is produced, which is involved in the breakdown of a number of food components. A small bubble, 8 to 14 cm long and 3-5 cm wide, is a storage facility where up to 40 mg of liquid can be stored. At the request of the body, bile is transported through the common bile duct into the duodenum. The secretion produced in the liver and stored under it is involved in the breakdown of fats, ensures the transition from gastric to intestinal digestion, and neutralizes the effect of pepsin, which is so unfavorable for the pancreas. The acids contained in bile activate small intestinal motility, stimulate the production of mucus and hormones involved in digestion, and activate enzymes involved in the breakdown of proteins.

Bile is also actively involved in excretory function. It removes up to 70 percent of cholesterol, bilirubin, some metals, glutathione and steroids from the body. The remaining approximately one-third of the cholesterol is reabsorbed by the intestines.

Gallbladder diseases

But no matter how diligently nature (or God) takes care of protecting a small but such an important organ, a person with improper nutrition and not always in a healthy way life has done everything possible for the appearance of pathological processes and diseases in this organ, such as inflammation of the gallbladder, gallstones and polyps. Usually, inflammation of the gallbladder and cholelithiasis are concomitant, but which of the two diseases is primary, doctors disagree on this issue. How – you will learn about this and much more below.

Inflammation of the gallbladder. What is cholecystitis and why does it occur?

Clear localization of pain in gallbladder disease

Cholecystitis - that's what it's called pathological process, developing on the mucous membrane of the gallbladder. As a rule, this pathology affects older people, and women are twice as likely as men. The causes of this disease are:

1. protozoa (giardia);
2. microorganisms such as streptococci, staphylococci, E. coli and some others);
3. worms.

Moreover, staphylococci and E. coli more often than others provoke inflammatory processes in the bile-forming organ, actively multiplying when the immune system is weakened. The infection enters it with blood or lymph from the intestines. Stagnant bile in the bladder or its ducts promotes the proliferation of microflora. Stagnation of bile secretion occurs for the following reasons:

• overeating – excessively high-calorie foods change chemical composition bile secretion;
• non-compliance with the diet (snacks in between, eating at night);
• sedentary work, lack of physical activity;
• hormonal changes in women (especially during pregnancy);
• age-related changes in the body, plus genetic predisposition;
• diabetes.

Inflammation in children can be caused by Giardia or Ascaris.

Classification of cholecystitis

Cholecystitis, like most inflammatory diseases, can be acute or chronic. Cholecystitis in acute form lasts for a quarter, chronic can last up to six months, at which time temporary remissions and improvements may occur. The disease is classified according to the severity of the inflammatory process:

• Catarrhal cholecystitis is characterized by external pathology of the mucous membrane of the organ, redness and swelling are observed on it;
• Phlegmonous cholecystitis fills all layers with purulent exudate (consisting of dead leukocytes) muscle tissue bubble;
• Gangrenous cholecystitis is characterized by an inflammatory process with necrosis of gallbladder tissue.

Stones in the gallbladder

Stones in the gallbladder

Inflammation of the gallbladder can occur with or without the formation of stones. Cholecystitis without stones usually occurs in an acute form. Calculous cholecystitis, that is, inflammation with the presence of stones, is inherent in a chronic disease. Hard formations often formed in the gallbladder clog the bile ducts, which leads to stagnation of bile and, accordingly, to inflammation. One of the reasons for the appearance of stones is the high content of cholesterol in fatty foods. Sometimes small stones themselves go through the ducts into the small intestine and are excreted from the body, and then the pain disappears. Supporters of this theory believe that stone formation is primary, and leads to cholecystitis, causing blockage of the bile ducts.

According to another theory, stones are formed as a result of cholecystitis, as a result of an already formed stagnation of the gallbladder secretion. But both theories came to the unanimous opinion that the cholesterol contained in excessively fatty foods is to blame for the pathologies of this organ. It is this substance that crystallizes and forms stones. Cholecystitis and the presence of stones in the bladder are diagnosed using ultrasound or x-rays. Most gallstones can live in the gallbladder for several years without causing any problems. And the patient may not even be aware of their existence. If you still experience pain, or the presence of stones is detected during the examination for other reasons, the doctor may prescribe medications, dissolving solid formations. Such conservative treatment can last for several months, during which the patient is under the supervision of a doctor, undergoes regular examinations.

But if the duct is blocked, then the circulation of bile is disturbed, and the development of cholecystitis in an acute form begins. In such a situation, the doctor decides to remove the gallbladder, because a neglected disease can lead to rupture of the organ, or inflammation can affect the liver, diaphragm, and pancreas.

polyps

Bile plays an important role in the human body

It has been noted that polyps in the gallbladder most often occur in women over 35 years of age - more than 80 percent of cases. But these statistics may be overestimated, since ultrasound does not always correctly show the nature of tumors. And very often soft, loose stones are mistaken for polyps. The formation of polyps is usually asymptomatic and does not manifest itself in any way. And if painful sensations nevertheless appear, then it is generally accepted that these are still stones.

There are three types of polyps. The first two belong to pseudotumors. These are cholesterol and inflammatory. Outwardly, they are similar to neoplasms, however, the nature of these growths is different. True polyps include papillomas and papillary neoplasms. They are considered benign, however, in 10-30 percent of episodes they degenerate into a malignant tumor. And it still remains unclear what exactly provokes such a rebirth.

Treatment of cholesterol polyps is possible by conservative medication. Since these are soft stones, drugs such as ursofalk or ursosan dissolve them and help to remove them from the bladder cavity. The patient is under the supervision of a doctor throughout the treatment.

In what cases is surgery justified?

The gallbladder plays an important role in the body, and its removal introduces an imbalance and forces the entire body to rebuild. digestive system. Therefore, the doctor tries to the last to preserve this small, but such an important organ. The decision to remove is made only when its preservation threatens the life of the patient. Blocking of the ducts with stones can lead to rupture of the gallbladder and inflammatory damage to other organs - the liver, diaphragm, intestines. The growth of polyps by 2 mm per year also indicates possible degeneration benign polyps into a life-threatening oncological tumor, and therefore is an indication for surgical intervention.

You can learn more about such an organ as the gallbladder from the video:

If you do not know where such an organ as the gallbladder is located, then you have never had problems associated with it. However, if the state of health is not in order, especially from the side of digestion, you should figure out what functions are inherent in it.

Main function of the gallbladder

The gallbladder is located under the liver

The gallbladder is an organ located on the lower surface of the liver and adjacent to it. It performs a deposition function, which, as the name implies, means the accumulation of bile coming from the liver.

This organ is located in the right longitudinal hepatic groove and has a relatively small size - its length varies from 8 to 14 cm, and its width is no more than 5 cm. In addition to this main function, the gallbladder has a number of others, no less important:

• Concentration - bile coming from the liver to the gallbladder is concentrated and changes its density
• Absorption - bile components can be absorbed through the wall of the organ, which helps cleanse the body
• Evacuation - as a result of contraction of the gallbladder during the digestion process, bile is released into the duodenum
• Valve - depending on the processes occurring in the body, provides patency or obstruction of bile into the intestines.

These functions are important, however, in addition to them, there are a number of others - with the direct participation of this organ, the lipase enzyme is activated, on which the digestion of fats depends, and the growth of pathogenic intestinal microflora slows down.

Violations in the work of the body

Due to its very modest size, this small organ and the importance it has in the human body are often underestimated. However, if its functioning is disrupted, a person develops serious problems. The reasons for the malfunction of this organ can be considered:

1. Psycho-emotional factor - any stress, emotional overload, nervous shocks and other problems associated with the mental sphere of life negatively affect the work of the biliary system.
2. Violation hormonal levels or hormonal disorders. IN female body this cause is most often provoked by the onset of the menstrual cycle or menopause. The hormonal balance is also strongly influenced by the state of pregnancy and subsequent childbirth.
3. Pathologies of the liver and kidneys, formation of stones (calculi).
4. Diabetes.
5. Inflammation caused by an advanced infection or severe cold.

The main problem of disrupting the proper functioning of the gallbladder is the accumulation and poor permeability of bile, which, in turn, is accompanied by very painful symptoms:

• Colic and prolonged spasms
• Dull pain in the hypochondrium
• Prolonged nausea and vomiting
• Bad taste in mouth
• Fever, shaking and chills
• Constant fatigue.

On average, the body of a healthy adult accumulates about 50 ml of bile in the gallbladder. Up to 30 ml of fluid can accumulate in a child's gallbladder. However, with serious diseases, the volume of accumulated bile increases, which may indicate problems associated not only with this organ, but also with the liver.

Diagnosis of diseases is most effective way performed using ultrasound abdominal cavity and the gallbladder as well. As additional methods research uses radioisotope aspects of diagnostics.

Classification of diseases

Stones in the gallbladder

The main disease of the gallbladder is its dysfunction, that is, disruption of the organ’s functioning. However, the dysfunction itself has two types of classification:

• Slow or hypomotor dysfunction. Characteristic symptoms for this dysfunction are a feeling of pressure and fullness, dull aching pain under the ribs on the right, bitterness in the mouth, vomiting and constipation, flatulence and bloating.
• Hypermotor or rapid dysfunction. Most often it occurs against a background of increased stress or psycho-emotional overload. Pain with this type of dysfunction often radiates to the back or the heart area, provided that other common symptoms of the pathology of this organ persist.

The symptoms of each type depend not only on the cause of the complication, but also on the stage of development of the disease, on the degree of its neglect.

Treatment Methods

The main task in identifying gallbladder pathologies is to normalize and stabilize the patient’s condition. Most often, this is enough to follow bed rest, a special diet and avoid stressful situations. The diet that doctors recommend when problems related to the gallbladder arise allows bile not to stagnate, but to empty all ducts in a timely manner.

The main idea of ​​this diet is to split your daily diet into 5-6 servings of food, provided they are small. In addition, the last meal should be quite late, so that the problem organ disperses bile throughout the body even at night (during sleep). Useful products, which can and should be consumed on a special diet that restores the functioning of the gallbladder, are:

• Meat, poultry and fish
• Mushroom dishes
• Low-fat broths and soups
• Products containing natural fats in large quantities.

How drug treatment For diseases, drugs such as atropine sulfate, Besalol and Eufillin help well. They are taken both in the form of intramuscular injections and in the form of capsules and tablets. For severe and persistent pain, it is recommended to take a painkiller - No-shpu or Papazol.

It should be noted that although the dosage of each drug is purely individual, the prescription of the drug for children differs significantly in quantity from the treatment for adults. To obtain more accurate information, you should carefully study the instructions included with the medication or consult your doctor.

Take off unpleasant symptoms On the part of the gallbladder, not only medications will help, but also ordinary herbs and herbs that are more gentle than chemicals.

Herbs such as St. John's wort, valerian and mint, sage, calendula, thyme and chamomile, plantain, flax, celandine, and a number of others improve the performance of the diseased organ. Infusions brewed based on these medicinal herbs, can significantly improve the condition of the body (especially if you correctly combine the means traditional medicine and medications prescribed by a doctor).

Possible problems and complications

Gallbladder removal surgery

In addition to dysfunction of the gallbladder, there are a number of others. Sometimes more serious dangers associated with diseases of this organ:

1. The inflammatory process that arises in the ducts of the bladder, in the absence of proper treatment, risks turning into a disease such as cholecystitis. Infectious pathogens are most often staphylococci and streptococci, as well as E. coli and many others.
2. Gallstone disease occurs against the background of decreased production of bile acids and increased cholesterol formation. The disease is characterized by the formation of crystal formations from calcium salts in the gallbladder itself and its ducts. Often, a person suffering from gallstone disease needs surgical intervention.
3. Various tumors of the organ and its ducts are characterized by symptoms that can easily be confused with chronic cholecystitis - general weakness and malaise, itching and others. If the tumor significantly interferes with a person’s life, urgent surgical intervention is necessary.

An advanced disease can cause the entire organ to be removed.

The consequences of advanced gallbladder disease are always extremely unpleasant and dangerous - if treatment is not started in a timely manner, a person can develop quite serious consequences in the form of disruption of the process of bile outflow, which, in turn, can lead to infectious infection, purulent inflammation of the walls of the organ and various abscesses.

Remember that if problems arise with this organ, you must immediately consult a doctor who, after a thorough examination, will prescribe the appropriate treatment for you.

What does the gallbladder do in the body, what functions does it perform? The answers are in the video:

The feeling of bitterness in the mouth and nausea in the morning are familiar to many people. Usually these symptoms are attributed to diseases of the stomach, but these unpleasant sensations can be a sign of diseases of a completely different organ - the gallbladder.

Why does the body need bile?

Location of the gallbladder in the body: schematic illustration

The liver is an organ that performs several different vital functions at once, one of them is the formation of bile, a very important biological fluid involved in the digestive process. After bile is formed, the liver releases it through a duct into the gallbladder, an organ that looks similar to a pear. In the gallbladder, bile is collected and concentrated.

During the digestive process, concentrated bile may be released from the gallbladder, especially when eating fatty or fried foods. Normally, contractions of the gallbladder occur two hours after food enters the body, then bile is released into the intestines.

The main function of bile is the breakdown of fats entering the body to facilitate their further digestibility and activation of digestive enzymes involved in protein synthesis. The process of bile secretion stimulates the functioning of the intestines, stomach and regulates the production of pancreatic enzymes. Bile also has an antimicrobial function, preventing microbes from entering the intestines.

Location of the gallbladder in the body

The gallbladder is an organ the size of a quail egg, resembling a pouch, up to 10 cm long and up to 3 cm wide. It is located on the surface of the liver in a small depression 3 cm below the costal arch and is adjacent to the peritoneal wall. A healthy gallbladder is approximately located at the intersection of the rectus abdominis muscle with the right costal arch. In some cases, when the liver is located lower than in most people, the gallbladder comes into contact with loops of intestine. The following abnormal locations of the gallbladder may occur:

1. Intrahepatic
2. Wandering

In the latter case, the bubble can change its location depending on movement and neighboring organs. In many people, two-thirds of the gallbladder is closed by the peritoneum, and in some people, except for the duct connecting it to the liver, the vessels and nerves of the duct also remain open. To the right of this organ is the transverse bypass, which is located across the abdominal cavity, and the upper part of the duodenum, to the left is the stomach.

Location of the gallbladder in children

Location of the gallbladder in the body: relative to internal organs

In a newborn child, the liver is located below the ribs by an average of 3 cm, and by the age of five this distance is reduced to 2 cm. In a seven-year-old child, the location of these organs is proportional to the structure of an adult. Until the age of ten, the gallbladder remains covered by the liver.

The location of the gallbladder in a child can be determined as follows: from the middle of the sternum and costal arch 2 cm below and to the right. This arrangement of organs is typical for most people, but not for everyone.

Anatomical structure

The gallbladder is divided into three parts:

• Sheik

The bottom stands out from the main part of this organ and is clearly visible when ultrasound examination. The body is the widest part, located between the duct to the liver and the bottom. The cervix is ​​the narrowest part and connects the gallbladder to the hepatic duct.

The duct is necessary for transporting bile; its length reaches up to 4 cm. The bladder can hold up to 50 ml of bile inside. If necessary, bile is released through the small duct. This process is controlled by the autonomic nervous system; the stimulus for giving a signal is the beginning of the digestive process. The pancreatic duct connecting to the liver is called the ductal pancreatic ampulla. The walls of the bladder consist of the following shells:

• Epithelium (internal)
• Muscular mucosa
• Serous (external)

The mucous membrane has many folds and contains mucous glands; it is capable of intensively absorbing liquids, so the bile entering the bladder is concentrated several times compared to what has just arrived from the liver. The folds of the mucosa are arranged in a spiral, due to which bile moves in two directions.

The muscle fibers connecting the sphincter to the ductal-pancreatic ampulla are called the sphincter of Oddi. It regulates the flow of bile, its outflow and prevents bile from flowing into the common bile duct.

Blood supply

Pain in the solar plexus in case of gallbladder disease

Arterial blood enters the gallbladder through the portal artery, which arises from the liver. The removal of venous blood from the neck and duct is carried out through the bile vein. And the entry of venous blood from the body and fundus occurs through the visceral part of the liver through sinusoids. Lymph moves through the lymphatic vessels into cystic nodes located near the liver, which in turn are sent to the abdominal lymph nodes.

innervation

Nerve endings regulate the functions of the gallbladder, stimulate the contraction of the sphincters and cause pain when pathological changes or inflammatory processes. Innervation of the gallbladder:

1. Nervus vagus
2. phrenic nerve bundle
3. Solar plexus

Functions

The main function of the gallbladder is to store bile until the body needs it.

• Bile accumulation
• Storage
• Increasing the concentration of bile
• Secretion of bile by muscle contractions

The increase in bile concentration is due to the fact that the body needs to store a large volume of bile in a small volume. That is, in 50 ml of bile the same amount of active components is dissolved as in 1 liter.

In the absence of digestion, the pancreatic sphincters are closed and do not allow bile to flow out. As soon as they receive nerve impulse When digestion begins, the sphincters relax and bile flows into the duodenum.

Bile may have a light yellow or brown tint. Liver bile is light in color and turns brown as it concentrates in the gallbladder. Regulate the secretion of bile by hormonal and nervous systems. The hormone secretin, as well as fatty substances, stimulates the contraction of the sphincters.

Gland disorders

Gallstones: photo

If the bile ducts are not functioning properly, bile may accumulate in the gallbladder. It is highly concentrated and crystallized. Typically, bile buildup occurs around cholesterol. Thus, stones begin to form. There are many small stones that, passing through the ducts into the intestines, cause severe pain.

Sometimes quite large stones form. This disease is called cholelithiasis. The disease occurs in several stages and is accompanied by the following symptoms:

• Intense pain
• Spasms
• Symptom of "acute abdomen"
• Vomit
• Bitterness in the mouth
• Constipation
• Diarrhea
• Urinary dysfunction
• Yellowness of the whites of the eyes

The acute phase of the disease develops quickly and occurs suddenly; very often the onset of an attack does not foretell anything. But malfunction of the gallbladder can be determined by the following signs: nausea and a pressing sensation on the right side. This happens when the stone begins to move, the pain will be more intense the larger the stone.

Another disease of the gallbladder is cholecystitis, which is accompanied by an inflammatory process. The acute phase of the disease occurs due to infections entering the body. Chronic illness develops against the background of poor nutrition.

Causes of violations

Food must be supplied regularly to the digestive system. The bile accumulated in the bladder must be constantly released into the intestines. When these processes are disrupted, diseases develop: the formation of stones and inflammation. In the absence of constant nutrition, bile is not released and does not leave the bladder.

Food must enter the body at least three times a day, otherwise the concentration of bile exceeds the norm. Fatty foods stimulate the active release of bile, which causes a bitter taste in the mouth. Therefore, it is necessary to adhere to a balanced diet to activate the sphincters and timely excretion of bile. Impaired functioning of the gallbladder can be caused by liver failure.

It can develop against the background of alcohol abuse and fatty foods and lead to malfunctions of the bladder. Excess bile, which penetrates into the gallbladder due to these disorders, can provoke its decomposition. The cause of this process is sometimes an excess or lack of cholesterol in the body. Very rarely, cholelithiasis develops for hereditary reasons or due to hypovitaminosis.

If you do not monitor the health of the gallbladder and do not treat it on time, diseases of other organs will develop. For the normal functioning of all organs and systems of the human body, timely and proper nutrition and active movement. Overeating and undereating will cause problems in the body. The secret to maintaining a healthy liver and gallbladder is quite simple - moderation!

The structure, functions and diseases of the gallbladder, its connection with the liver - the topic of the video:

gallbladder, vesica fellea (biliaris), is a sac-shaped reservoir for bile produced in the liver; it has an elongated shape with wide and narrow ends, and the width of the bladder from the bottom to the neck decreases gradually. The length of the gallbladder ranges from 8 to 14 cm, the width is 3-5 cm, the capacity reaches 40-70 cm 3. It has a dark green color and a relatively thin wall.

In the gallbladder, the fundus of the gallbladder, fundus vesicae felleae, is its most distal and wide part; the body of the gallbladder, corpus vesicae felleae, is the middle part and the neck of the gallbladder, collum vesicae felleae, the proximal narrow part from which the cystic duct arises. ductus cysticus. The latter, connecting with the common hepatic duct, forms the common bile duct, ductus choledochus.

The gallbladder lies on the visceral surface of the liver in the gallbladder fossa, fossa vesicae felleae, separating the anterior section right lobe from the square lobe of the liver. Its bottom is directed forward to the lower edge of the liver in the place where the small notch is located, and protrudes from under it; the neck faces the porta hepatis and lies together with the cystic duct in the duplication of the hepatoduodenal ligament. At the junction of the body of the gallbladder and the neck, a bend is usually formed, so the neck appears to lie at an angle to the body.

The gallbladder, located in the fossa of the gallbladder, is adjacent to it with its upper surface, devoid of peritoneum, and is connected to the fibrous membrane of the liver. Its free surface, facing down into the abdominal cavity, is covered with a serous layer of visceral peritoneum, passing onto the bladder from the adjacent areas of the liver. The gallbladder can be located intraperitoneally and even have a mesentery. Usually, the bottom of the bladder protruding from the liver notch is covered with peritoneum on all sides.

The structure of the gallbladder.

The structure of the gallbladder. The wall of the gallbladder consists of three layers (with the exception of the upper extraperitoneal wall): the serous membrane, tunica serosa vesicae felleae, the muscularis membrane, tunica muscularis vesicae felleae, and the mucous membrane, tunica mucosa vesicae felleae. Under the peritoneum, the wall of the bladder is covered by a thin loose layer connective tissue- subserosa base of the gallbladder, tela subserosa vesicae felleae; on the extraperitoneal surface it is more developed.

The muscular layer of the gallbladder, tunica muscularis vesicae felleae, is formed by one circular layer of smooth muscle, among which there are also bundles of longitudinally and obliquely arranged fibers. The muscle layer is less pronounced in the bottom area and stronger in the cervical area, where it directly passes into muscle layer cystic duct.

The mucous membrane of the gallbladder, tunica mucosa vesicae felleae, is thin and forms numerous folds, plicae tunicae mucosae vesicae felleae, giving it the appearance of a network. In the cervical region, the mucous membrane forms several oblique spiral folds, plicae spirales, running one after the other. The mucous membrane of the gallbladder is lined with single-row epithelium; in the cervical region there are glands in the submucosa.

Topography of the gallbladder.

Topography of the gallbladder. The bottom of the gallbladder is projected on the anterior abdominal wall in the angle formed by the lateral edge of the right rectus abdominis muscle and the edge of the right costal arch, which corresponds to the end of the IX costal cartilage. Syntopically, the lower surface of the gallbladder is adjacent to the anterior wall of the upper part of the duodenum; on the right it is adjacent to the right flexure of the colon.

Often the gallbladder is connected to the duodenum or colon by a peritoneal fold.

Blood supply: from the gallbladder artery, a. cystica, branches of the hepatic artery.

Bile ducts.

There are three extrahepatic bile ducts: the common hepatic duct, ductus hepaticus communis, the cystic duct, ductus cysticus, and the common bile duct, ductus choledochus (biliaris).

The common hepatic duct, ductus hepaticus communis, is formed at the porta hepatis as a result of the fusion of the right and left hepatic ducts, ductus hepaticus dexter et sinister, the latter are formed from the intrahepatic ducts described above. Having descended as part of the hepatoduodenal ligament, the common hepatic duct connects with the cystic duct a duct coming from the gallbladder; This is how the common bile duct, ductus choledochus, appears.

Cystic duct, ductus cysticus, has a length of about 3 cm, its diameter is 3-4 mm; the neck of the bladder forms two bends with the body of the bladder and with the cystic duct. Then, as part of the hepatoduodenal ligament, the duct is directed from top to right down and slightly to the left and usually merges with the common hepatic duct at an acute angle. The muscular layer of the cystic duct is poorly developed, although it contains two layers: longitudinal and circular. Along the cystic duct, its mucous membrane forms a spiral fold, plica spiralis, in several turns.

Common bile duct, ductus choledochus. embedded in the hepatoduodenal ligament. It is a direct continuation of the common hepatic duct. Its length is on average 7-8 cm, sometimes reaching 12 cm. There are four sections of the common bile duct:

1. located above the duodenum;
2. located behind the upper part of the duodenum;
3. lying between the head of the pancreas and the wall of the descending intestine;
4. adjacent to the head of the pancreas and passing obliquely through it to the wall of the duodenum.

The wall of the common bile duct, in contrast to the wall of the common hepatic and cystic ducts, has a more pronounced muscular layer, forming two layers: longitudinal and circular. At a distance of 8-10 mm from the end of the duct, the circular muscle layer is thickened, forming the sphincter of the common bile duct, m. sphincter ductus choledochi. The mucous membrane of the common bile duct does not form folds, with the exception of the distal section, where there are several folds. In the submucosa of the walls of the non-hepatic bile ducts there are mucous glands of the bile ducts, glandulae mucosae biliosae.

The common bile duct connects with the pancreatic duct and flows into a common cavity - the hepatopancreatic ampulla, ampulla hepatopancreatica, which opens into the lumen of the descending part of the duodenum at the top of its major papilla, papilla duodeni major, at a distance of 15 cm from the pylorus of the stomach. The ampoule size can reach 5×12 mm.

The type of entry of the ducts can vary: they can open into the intestine with separate mouths, or one of them can flow into the other.

In the area of ​​the major papilla of the duodenum, the mouths of the ducts are surrounded by a muscle - this is the sphincter of the hepatopancreatic ampulla (sphincter of the ampulla), m. sphincter ampullae hepatopancreaticae (m. sphincter ampulae). In addition to the circular and longitudinal layers, there are separate muscle bundles that form an oblique layer, which unites the sphincter of the ampulla with the sphincter of the common bile duct and with the sphincter of the pancreatic duct.

Topography of the bile ducts. The extrahepatic ducts are located in the hepatoduodenal ligament along with the common hepatic artery, its branches and the portal vein. At the right edge of the ligament is the common bile duct, to the left of it is the common hepatic artery, and deeper than these formations and between them is the portal vein; in addition, lymphatic vessels, nodes and nerves lie between the leaves of the ligament.

The division of the proper hepatic artery into the right and left hepatic branches occurs in the middle of the length of the ligament, and the right hepatic branch, going upward, passes under the common hepatic duct; at the place of their intersection, the gallbladder artery departs from the right hepatic branch, a. cystica, which is directed to the right and upward into the region of the angle (gap) formed by the fusion of the cystic duct with the common hepatic duct. Next, the gallbladder artery passes along the wall of the gallbladder.

Innervation: liver, gall bladder and bile ducts - plexus hepaticus (truncus sympathicus, nn. vagi).

Blood supply: liver - a. hepatica propria, and its branch a. cystica approaches the gallbladder and its ducts. In addition to the artery, the portal of the liver includes v. portae, collecting blood from unpaired organs in the abdominal cavity; passing through the system of intraorgan veins, it leaves the liver through vv. hepaticae. flowing into v. cava inferior. Venous blood flows from the gallbladder and its ducts into the portal vein. Lymph is drained from the liver and gall bladder in nodi lymphatici hepatici, phrenici superior et inferior, lumbales dextra, celiaci, gastrici, pylorici, pancreatoduodenales, anulus lymphaticus cardiae, parasternales.

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gallbladder

gallbladder

gallbladder is a reservoir for storing bile. It is an elongated bag 8–12 cm long, 4–5 cm wide, with an expanded bottom resembling a pear in shape, with a capacity of about 40 cm 3 ; its wide end forms bottom, narrowed – neck, turning into cystic duct, through which bile enters and is released from the bladder. Between the bottom and the neck is located bubble body. The folded mucous membrane is lined with a single-layer columnar epithelium with a striated border of microvilli, which intensively absorbs water, so the gallbladder bile thickens 3-5 times compared to bile from the common hepatic duct.

The cystic duct, connecting with the common hepatic duct, forms common bile duct, which is directed downward, pierces the descending part of the duodenum, merging with the pancreatic duct and opening at the apex of the major duodenal papilla. At the confluence of the two ducts there is an expansion of the hepatopancreatic ampulla. Bundles of muscle fibers surround the end of the common bile duct in the thickness of the intestinal wall, forming a poorly developed sphincter ampulla(soda), which prevents the contents of the duodenum from flowing into the bile and pancreatic ducts. Above the sphincter, above the junction of the pancreatic duct with the common bile duct, there is another powerful sphincter of the common bile duct, which, in fact, regulates the flow of bile into the duodenum.

Hepatic bile is concentrated in the gallbladder; gallbladder bile contains less water, more bile acids, bilirubin, and cholesterol. Bile performs many important functions. It neutralizes hydrochloric acid, inactivates pepsin, enhances the activity of pancreatic enzymes, facilitates the breakdown of fats, accelerates the absorption of fatty acids, and prevents putrefaction in the colon.