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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/07/04 20:11:36」(JST)

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Digestive system diagram showing the common bile duct

The hepatobiliary system refers to the liver, gall bladder and bile ducts, and how they work together to make bile. Bile consists of water, electrolytes, bile acids, cholesterol, phospholipids and conjugated bilirubin. Some components are synthesised by liver cells, the rest are extracted from the blood by the liver.

Structure

Bile is secreted by the liver into small ducts that join to form the common hepatic duct. Between meals, secreted bile is stored in the gall bladder, where 80%-90% of the water and electrolytes can be absorbed, leaving the bile acids and cholesterol. During a meal, the smooth muscles in the gallbladder wall contract, leading to the bile being secreted into the duodenum.

Biliary tract

The biliary tract (or biliary tree, biliary system) is the common anatomical term for the path by which bile is secreted by the liver then transported to the first part of the small intestine, also known as the duodenum. A structure common to most members of the mammal family, it is referred to as a tree because it begins with many small branches which end in the common bile duct, sometimes referred to as the trunk of the biliary tree. The duct, the branches of the hepatic artery, and the portal vein form the central axis of the portal triad. Bile flows in the direction opposite to that of the blood present in the other two channels.

The name usually excludes the liver,^[1] but sometimes does include it.^[2]

The path is as follows:

Bile canaliculi >> Canals of Hering >> intrahepatic bile ductule (in portal tracts / triads) >> interlobular bile ducts >> left and right hepatic ducts >>
merge to form >> common hepatic duct >>
exits liver and joins >> cystic duct (from gall bladder) >>
forming >> common bile duct >> joins with >> pancreatic duct >>
forming >> ampulla of Vater >> enters duodenum

Function

To see how this relates to the metabolism of bile, read bilirubin metabolism.

Clinical significance

Pressure inside in the biliary tree can give rise to gallstones and lead to cirrhosis of the liver.

The biliary tract can also serve as a reservoir for intestinal tract infections. Since the biliary tract is an internal organ, it has no somatic nerve supply, and biliary colic due to infection and inflammation of the biliary tract is not a somatic pain. Rather, pain may be caused by luminal distension, which causes stretching of the wall. This is the same mechanism that causes pain in bowel obstructions.^{[citation needed]}

An obstruction of the biliary tract can result in jaundice, a yellowing of the skin and whites of the eyes. ^[3]

References

^ Biliary tract at the US National Library of Medicine Medical Subject Headings (MeSH)
^ "Dorlands Medical Dictionary:biliary tract".
^ "Definition: biliary tract from Online Medical Dictionary".

UpToDate Contents

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1. 嚢胞性線維症：肝胆道系疾患 cystic fibrosis hepatobiliary disease
2. 急性胆嚢炎：病因、臨床的特徴、および診断 acute cholecystitis pathogenesis clinical features and diagnosis
3. 肝胆道のCT撮影 computed tomography of the hepatobiliary tract
4. 肝胆道の超音波検査 ultrasonography of the hepatobiliary tract
5. Causes of abdominal pain in adults

English Journal

Cystic fibrosis and AA amyloidosis: a survey in the French cystic fibrosis network.

Stankovic Stojanovic K1, Hubert D, Leroy S, Dominique S, Grenet D, Colombat M, Clement A, Fayon M, Grateau G.
Amyloid : the international journal of experimental and clinical investigation : the official journal of the International Society of Amyloidosis.Amyloid.2014 Dec;21(4):231-7. doi: 10.3109/13506129.2014.943834. Epub 2014 Jul 23.
Abstract Introduction: To define the characteristics of CF patients developing AA amyloidosis.METHODS: A 30-year retrospective survey conducted within the national French CF network to identify cases of CF associated with AA amyloidosis.RESULTS: Nine cases of AA amyloidosis were identified (CF preva
PMID 25054230

Role of (drug) transporters in imaging in health and disease.

Stieger B1, Unadkat JD2, Prasad B2, Langer O2, Gali H2.
Drug metabolism and disposition: the biological fate of chemicals.Drug Metab Dispos.2014 Dec;42(12):2007-15. doi: 10.1124/dmd.114.059873. Epub 2014 Sep 23.
This report is the summary of presentations at the symposium sponsored by the American Society for Pharmacology and Experimental Therapeutics, April 26-30, at Experimental Biology 2014 in San Diego, CA. The presentations focused on the role of transporters in imaging in health and disease and on ass
PMID 25249691

miR‑96 functions as a tumor suppressor gene by targeting NUAK1 in pancreatic cancer.

Huang X1, Lv W2, Zhang JH3, Lu DL1.
International journal of molecular medicine.Int J Mol Med.2014 Dec;34(6):1599-605. doi: 10.3892/ijmm.2014.1940. Epub 2014 Sep 19.
microRNA‑96 (miR‑96) is known to be downregulated in pancreatic cancer. The overexpression of miR‑96 in MIA PaCa‑2 pancreatic cancer cells has been shown to inhibit cell proliferation, migration and invasion; however, the mechanisms involved have not yet been fully elucidated. Novel (nua)
PMID 25242509

Japanese Journal

Additional Value of Diffusion-weighted MRI to Gd-EOB-DTPA-enhanced Hepatic MRI for the Detection of Liver Metastasis : the Difference Depending on the Experience of the Radiologists