WordNet

relating to the bile ducts or the gallbladder
irritate or vex; "It galls me that we lost the suit" (同)irk
a skin sore caused by chafing
abnormal swelling of plant tissue caused by insects or microorganisms or injury

PrepTutorEJDIC

《古》(特に牛の)胆汁(たんじゅう) / (経験などの)苦さ,苦々しい思い《+『of』+『名』》 / 《英話》(…する)厚かましさ,ずうずうしさ《+『to』 do》
(皮膚の)すり傷;(特に馬具による馬の)くらずれ / …‘の'皮膚(皮)をすりむく / 〈人〉‘を'いらだたせる / すれてひりひりする,すりむける
虫こぶ(昆虫の働きによって樹木,特にカシの木の葉などにできる)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/05/01 22:31:17」(JST)

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1. Bile ducts: 2. Intrahepatic bile ducts, 3. Left and right hepatic ducts, 4. Common hepatic duct, 5. Cystic duct, 6. Common bile duct, 7. Ampulla of Vater, 8. Major duodenal papilla
9. Gallbladder, 10–11. Right and left lobes of liver. 12. Spleen.
13. Esophagus. 14. Stomach. Small intestine: 15. Duodenum, 16. Jejunum
17. Pancreas: 18: Accessory pancreatic duct, 19: Pancreatic duct.
20–21: Right and left kidneys (silhouette).

The anterior border of the liver is lifted upwards (brown arrow). Gallbladder with Longitudinal section, pancreas and duodenum with frontal one. Intrahepatic ducts and stomach in transparency.

A bile duct is any of a number of long tube-like structures that carry bile.

Bile, required for the digestion of food, is secreted by the liver into passages that carry bile toward the hepatic duct, which joins with the cystic duct (carrying bile to and from the gallbladder) to form the common bile duct, which opens into the intestine.

The biliary tree (see below) is the whole network of various sized ducts branching through the liver.

The path is as follows: Bile canaliculi → Canals of Hering → interlobular bile ducts → intrahepatic 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

Structure

Bile duct is green like the gallbladder, because of bile stains.

Innervation

Inflation of a balloon in the bile duct causes, through the vagus nerve, activation of the brain stem and the insular cortex, prefrontal cortex, and somatosensory cortex.^[1]

Clinical relevance

Blockage of the bile duct by a cancer, gallstones, or scarring from injury prevents the bile from being transported to the intestine and the active ingredient in the bile (bilirubin) instead accumulates in the blood. This condition results in jaundice, where the skin and eyes become yellow from the bilirubin in the blood. This condition also causes severe itchiness from the bilirubin deposited in the tissues. In certain types of jaundice, the urine will be noticeably darker, and the stools will be much paler than usual. This is caused by the bilirubin all going to the bloodstream and being filtered into the urine by the kidneys, instead of some being lost in the stools through the ampulla of Vater.

Jaundice

Jaundice is commonly caused by conditions such as pancreatic cancer, which causes blockage of the bile duct passing through the cancerous portion of the pancreas; cholangiocarcinoma, cancer of the bile ducts; blockage by a stone in patients with gallstones; and from scarring after injury to the bile duct during gallbladder removal.

Drainage

Biliary drainage is performed with a tube or catheter (called a biliary drain, biliary stent or biliary catheter) by a surgeon or, commonly, an interventional radiologist.^[2] It can be used to relieve a blockage in the bile duct, either permanently or as a temporary solution before definite treatment such as surgery. The drain can be placed percutaneously through the liver, with the procedure then being called percutaneous transhepatic biliary drainage (PTBD).^[3] This can additionally be performed as part of a percutaneous transhepatic cholangiography, then a form of interventional radiology. A biliary drain can also be used to take bile samples for diagnostic workup or disease monitoring, as well as providing a route of administration for medical substances.

In infants with biliary atresia, hepatoportoenterostomy is an alternative method of providing bile drainage.

Additional images

Section across portal canal of pig. ×250.
An intraoperative cholangiogram, which is an X-Ray of the bile ducts during a laprascopic cholecystectomy.
Bile duct.Deep dissection.Anterior view.

References

This article uses anatomical terminology; for an overview, see anatomical terminology.

^ Sai JK, Suyama M, Kubokawa Y, Matsumura Y, Inami K, Watanabe S, Kirino E. (2010). Identification of cerebral response to balloon distention of the bile duct. World J Gastroenterol. 16(14):1772-5. doi:10.3748/wjg.v16.i14.1772 PMID 20380011
^ Biliary Drain Patient information from The Ohio State University Medical Center. Retrieved May 2011
^ Kuhn, J. P.; Busemann, A.; Lerch, M. M.; Heidecke, C. D.; Hosten, N.; Puls, R. (2010). "Percutaneous Biliary Drainage in Patients with Nondilated Intrahepatic Bile Ducts Compared with Patients with Dilated Intrahepatic Bile Ducts". American Journal of Roentgenology 195 (4): 851–857. doi:10.2214/AJR.09.3461. PMID 20858809. edit

External links

Wikimedia Commons has media related to Bile duct.

The Cholangiocarcinoma Foundation
The Johns Hopkins Gall Bladder & Bile Duct Cancer Web page
bile+duct at eMedicine Dictionary
Bile Ducts at the US National Library of Medicine Medical Subject Headings (MeSH)

UpToDate Contents

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1. 急性胆管炎 acute cholangitis
2. 成人における胆嚢機能障害 functional gallbladder disorder in adults
3. 胆道閉鎖症 biliary atresia
4. 総胆管損傷の修復 repair of common bile duct injuries
5. オッディ括約筋機能不全の臨床症状よび診断 clinical manifestations and diagnosis of sphincter of oddi dysfunction

English Journal

Biliary-duodenal anastomosis using magnetic compression following massive resection of small intestine due to strangulated ileus after living donor liver transplantation: a case report.

Saito R1, Tahara H2, Shimizu S1, Ohira M1, Ide K1, Ishiyama K1, Kobayashi T1, Ohdan H1.
Surgical case reports.Surg Case Rep.2017 Dec;3(1):73. doi: 10.1186/s40792-017-0349-4. Epub 2017 May 25.
PMID 28547740

Pancreatic ductal adenocarcinoma with inferior vena cava invasion: a report of three resected cases.

Mizumoto T1, Goto T1, Toyama H2, Sofue K1, Asari S1, Terai S1, Tanaka M1, Kido M1, Ajiki T1, Fukumoto T1, Ku Y1.
Surgical case reports.Surg Case Rep.2017 Dec;3(1):72. doi: 10.1186/s40792-017-0348-5. Epub 2017 May 23.
PMID 28537015

Ruptured focal nodular hyperplasia observed during follow-up: a case report.

Kinoshita M1, Takemura S2, Tanaka S2, Hamano G2, Ito T2, Aota T2, Koda M2, Ohsawa M3, Kubo S2.
Surgical case reports.Surg Case Rep.2017 Dec;3(1):44. doi: 10.1186/s40792-017-0320-4. Epub 2017 Mar 17.
PMID 28315131