Anatomy of the Hepatobiliary System_Maran

8/7/2019 Anatomy of the Hepatobiliary System_Maran

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TOPIC OBSTRUCTIVE JAUNDICE

y Anatomy Nivash Maran. R

y Physiology Praveen. C

y Epidemiology & Pathogenesis y Clinical Features

y Management

y Recent Advances -



Nivash Maran . R



HepatobiliarySystem

y Liver

y Gallbladder

y Bile ductsy Pancreas



LI E

y Liver is the largest of theabdominal viscera

y Liver lies in the upper rightpart of the abdominal cavity,occupying most of the right

hypochondrium andepigastrium.

y Liver weighs roughly about2% of the adult body weight.

y BLOOD SUPPLY:

y Dual blood supply 80%nutrient-rich blood fromPortal Vein. 20% oxygen-richblood from Hepatic Artery.



y Liver weighs roughly about 2% of the adult body weight.

y BLOOD SUPPLY:y Dual blood supply 80% nutrient-rich blood from

Portal Vein. 20% oxygen-rich blood from Hepatic Artery.



y Classically liver is divided into left and right lobes by the main portal fissure which is also called theCantlies Line.

y Based on the hepatic blood supply, it can also bedivided into right and left hemilivers.

y According to Couinad classification, there are 8functionally independent segments in the liver.

y Each segment has its own vascular inflow, outflow and

biliary drainage.



y Bile is secreted by hepatocytes and flows through thecanaliculus into the bile ductule.

y The bile ductules join together to form largerintrahepatic bile ducts which in turn merge to form

the right and left HepaticD

ucts.

CENTRA LVEIN



Gallbladder

y The gallbladder is a flask-shaped organ attached to thecommon bile duct by the cystic duct.

y It is 7 10 cm long with a capacity of up to 50 ml.y It usually lies in a shallow fossa in the liver

parenchyma covered by peritoneum continued fromthe liver surface.



y Gallbladder has 3 parts Fundus, body and neck.

y Widening of the neck toform the body is called theHartmanns pouch.

y Blood supply is from the

cystic artery which arisesfrom the right hepaticartery.



y C ystic ct rai s t e all la er i t t e c e aticct t f r t e c ile ct.

y It is 3 4 c l .

y c sa f cystic ct ears 5 12 cresce tic f l sc ti s it t se i t e ec f t e all la er.



Bile uctsy Common Hepatic Duct:

y Right and Left hepatic ducts unite

to form the common hepatic duct.

y It is about 3 cm long.

y

Common BileD

uct:

y Cystic duct joins the common hepatic

duct and forms the common bile duct.

y It is about 8 cm long.

y It has parts:

1. Supraduodenal2. Retroduodenal

3. Infraduodenal

. Intraduodenal





Levels of obstruction in the biliary

tree



Pancreas

y Pancreas is both exocrine and endocrine organsituated retroperitoneally behind the stomach.

y

It extends from the duodenum on the right side to thespleen on the left side.

y Length is about 6 inches.



y Parts of Pancreas:

y Pancreas has parts

y Head

y Neck

y Body

y Tail



Pancreatic uct

y The main pancreatic duct (duct of Wirsung) drains thepancreas and joins the common bile duct forming the

Ampulla of Vater at the junction.y Ampulla opens in the 2nd part of the duodenum.

y Normal diameter is 2 3mm.

y Accessory pancreatic duct of Santorini drains the uncinateprocess and lower portion of the head and opens into the

duodenum 2 cm above the opening of the main duct.



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Anatomy of the Hepatobiliary System_Maran