EXTRA HEPATIC BILIARY APPARATUS

Extra Hepatic Biliary Apparatus

1. Parts of Extra Hepatic Biliary Apparatus

   • Common Hepatic Duct
   • Cystic Duct
   • Common Bile Duct
   • Right and Left Hepatic Ducts
   • Right and Left Branches of Common Hepatic Duct

2. Morphology of Gall Bladder

   • The gall bladder is a pear-shaped or oval organ.
   • It is situated under the liver in the gall bladder fossa.
   • It has a thick wall with a mucous membrane lining.
   • The mucous membrane has a series of longitudinal folds.
   • The interior has a fundus, body and neck.

3. Blood and Nerve Supply of Gall Bladder

   • Artery: Right Hepatic Artery (supplies most of the blood) and cystic artery (supplies blood to gall bladder).
   • Vein: Right Hepatic Vein.
   • Nerve: Right Hepatic Nerve (sympathetic and parasympathetic fibers).
   • The hepatic artery branches into right and left branches → cystic artery (branches off from right branch) → supplies blood to gall bladder.

4. Formation of Bile Duct

   • Bile from the liver is collected into right and left hepatic ducts.
   • Right and left hepatic ducts merge to form common hepatic duct.
   • Cystic duct (from gall bladder) merges with common hepatic duct to form common bile duct.
   • The common bile duct is joined by the common pancreatic duct to form ampulla of Vater.

5. Applied Anatomy

   • Laparotomy incision: The gall bladder is usually encountered during laparotomy incision in the upper right quadrant of the abdomen.
   • Cholecystectomy: The removal of the gall bladder involves cutting the cystic duct and artery, and then separating the gall bladder from the liver.
   • The common bile duct runs close to the superior mesenteric vessels and is at risk during surgical procedures.
   • The right hepatic artery is at risk during surgical procedures in the right upper quadrant of the abdomen.