関: choledochal、common bile duct

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/08/19 16:05:10」(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. 15. Pancreas: 16: Accessory pancreatic duct, 17: Pancreatic duct.
18. Small intestine: 19. Duodenum, 20. Jejunum
21–22: 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.

The common bile duct, sometimes abbreviated CBD,^[1] is a duct in the gastrointestinal tract of organisms that have a gall bladder. It is formed by the union of the common hepatic duct and the cystic duct (from the gall bladder). It is later joined by the pancreatic duct to form the ampulla of Vater. There, the two ducts are surrounded by the muscular sphincter of Oddi.

When the sphincter of Oddi is closed, newly synthesized bile from the liver is forced into storage in the gall bladder. When open, the stored and concentrated bile exits into the duodenum. This conduction of bile is the main function of the common bile duct. The hormone cholecystokinin, when stimulated by a fatty meal, promotes bile secretion by increased production of hepatic bile, contraction of the gall bladder, and relaxation of the Sphincter of Oddi.

Several problems can arise within the common bile duct. If clogged by a gallstone, a condition called choledocholithiasis can result.^[2] In this clogged state, the duct is especially vulnerable to an infection called ascending cholangitis. Very rare deformities of the common bile duct are cystic dilations (4 cm), choledochoceles (cystic dilation of the ampula of Vater (3–8 cm), and biliary atresia.

Additional images

Dilatation of CBD due to Ampullary tumor.
The gall-bladder and bile ducts laid open.

References

^ Agabegi, Steven S.; Agabegi, Elizabeth D. (23 August 2012). Step-Up to Medicine. Lippincott Williams & Wilkins. p. 136. ISBN 9781609133603.
^ Humes, H. David (2001). Kelley's Essentials of Internal Medicine. Lippincott Williams & Wilkins. p. 229. ISBN 978-0781719377.

S.E.Miederer et al.:Endoscopic transpapillary splitting of a choledochocele. Dtsch Med. Wochenschr. 1978 Feb.3:103(5):216,219. PMID 631041

External links

Anatomy figure: 38:06-08 at Human Anatomy Online, SUNY Downstate Medical Center - "The gallbladder and extrahepatic bile ducts."
Anatomy image:8336 at the SUNY Downstate Medical Center
Anatomy image:7957 at the SUNY Downstate Medical Center
liver at The Anatomy Lesson by Wesley Norman (Georgetown University) (biliarysystem)

UpToDate Contents

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1. 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

A simultaneous endoscopic and laparoscopic approach for management of early iatrogenic bile duct obstruction.

Sofi AA1, Tang J2, Alastal Y1, Nawras AT1.
Gastrointestinal endoscopy.Gastrointest Endosc.2014 Sep;80(3):511-5. doi: 10.1016/j.gie.2014.04.039. Epub 2014 Jun 11.
BACKGROUND: Bile duct occlusion secondary to inadvertent application of a surgical clip or suture usually is managed with endoscopic or surgical exploration.OBJECTIVE: To evaluate the safety and efficacy of a novel method of simultaneous endoscopic and laparoscopic approach in patients with acute ia
PMID 24929478

Endoscopic stenting in bile duct cancer increases liver volume.

Lee CH1, Kim SH1, Kim IH1, Kim SW1, Lee ST1, Kim DG1, Yang JD2, Yu HC2, Cho BH2, Lee SO1.
Gastrointestinal endoscopy.Gastrointest Endosc.2014 Sep;80(3):447-55. doi: 10.1016/j.gie.2014.01.051. Epub 2014 Mar 27.
BACKGROUND: Objective evaluation tools for assessing the effectiveness of stenting in palliative treatment of malignant biliary obstruction are not satisfactory. Effects of biliary stenting on liver volume change have never been studied.OBJECTIVE: We aimed to use volumetry to analyze liver volume ch
PMID 24679659

Residual disease predicts outcomes after definitive resection for incidental gallbladder cancer.

Butte JM1, Kingham TP1, Gönen M2, D'Angelica MI1, Allen PJ1, Fong Y1, DeMatteo RP1, Jarnagin WR3.
Journal of the American College of Surgeons.J Am Coll Surg.2014 Sep;219(3):416-29. doi: 10.1016/j.jamcollsurg.2014.01.069. Epub 2014 May 16.
BACKGROUND: Residual disease (RD) at definitive resection of incidental gallbladder cancer (IGBCA) influences outcome, but its clinical relevance with respect to anatomic site is incompletely characterized.STUDY DESIGN: Consecutive patients with IGBCA undergoing re-exploration from 1998 to 2009 were
PMID 25087941

Japanese Journal

症例報告小児総胆管多発結石症に対し鏡視下総胆管切開結石除去術を施行した1例

奥山直樹,窪田正幸,小林久美子 [他]
新潟医学会雑誌 126(1), 47-53, 2012-01-00
NAID 40019358929

輪状膵に合併した膵・胆管合流異常症の小児例

大割貢,小角卓也,大植孝治 [他],米倉竹夫,福澤正洋
日本小児外科学会雑誌 46(5), 884-888, 2010-08-20
患児は8歳女児.他院にて出生直後に先天性十二指腸閉鎖症(病型は不明)と診断され,十二指腸Diamond吻合術を施行された.染色体異常はなかった.術後,症状なく経過していたが,術後8年目に転居のため当科受診.肝胆膵精査目的に施行した超音波検査にて肝内胆管の拡張及び総胆管の拡張(11mm)を認めた.MRCP検査でも拡張した総胆管を描出した.そのため,膵・胆管合流異常に伴う胆道拡張症と診断し,胆嚢及び拡 …
NAID 110007682261

膵・胆管合流異常に対する腹腔鏡下手術 (特集肝・胆・膵領域における腹腔鏡下手術の最前線) -- (胆道領域)

村井信二,小島健司,赤津知孝 [他]
臨床外科 63(6), 797-802, 2008-06-00
NAID 40016049827

「choledochal」

Common bile duct
	Diagram of the biliary tree showing the common bile duct
Details
Identifiers
Latin	ductus choledochus
Acronym(s)	CBD
Dorlands; /Elsevier	d_29/12314771
FMA	14667
	Anatomical terminology [edit on Wikidata]

　　[★]

adj.

総胆管の

関: choledochus、common bile duct

[AgabegiAgabegi2012-1] Agabegi, Steven S.; Agabegi, Elizabeth D. (23 August 2012). Step-Up to Medicine. Lippincott Williams & Wilkins. p. 136. ISBN 9781609133603.

[2] Humes, H. David (2001). Kelley's Essentials of Internal Medicine. Lippincott Williams & Wilkins. p. 229. ISBN 978-0781719377.

匿名

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案内

案内

choledochus