THE GALL BLADDER AND BILE DUCTS


Location / position
  • Right hypochondrium

  • Tip of the 9 th costal cartilage in the mid-clavicular line

  • where the linear semilunaris meets the costal margin.

  • Visceral surface of liver

  • Along right edge of the quadrate lobe of the liver.
   

Relations  
Superior surface is in contact with the liver.

Its inferior and fundus in contact with:

  • Transverse colon
  • Superior part of the duodenum
  • Anterior abdominal wall.

The neck of the gall bladdes tapers towards the porta hepatis.

The epiploic foramen lies immediately to its left.

   

Peritoneal relations  
  • Covered on the posterior and inferior surfaces by peritoneum.
  • Occasionally, the gall bladder is completely invested with peritoneum, and may be connected to the liver by a short mesentry.
   

Blood supply  

Arterial :

Cystic artery commonly a branch of the right hepatic between hepatic duct and cystic duct. The origin and course of this artery is variable. It may arise from:

  • Common hepatic
  • Left hepatic
  • Superior epigastric
  • Left gastric
  • Left hepatic
  • Gastroduodenal
  • Superior mesenteric
  • Coeliac trunk

It commonly runs posterior to hepatic duct, but may run anterior .

   

Veins :  

Those from the ducts and neck of gall bladder join veins which connect the

  • Gastric
  • Duodenal
  • Pancreatic
  • Portal vein
  • Some go to the liver directly.
   

Lymphatics
  1. Cystic node at the neck of the gall bladder.
  2. Node of epiploic foramen hepatic nodes coeliac lymph nodes
   

Innervation
  1. Sensory innervation - phrenic nerve
  2. Sympathetic - coeliac plexus
  3. Parasympathetic - vagus
   

Organs of supracolic compartment