Bilious channels

Bilious channels. General characteristic

Bilious channels – system of the channels intended for removal of bile in a duodenum from a gall bladder and a liver. The innervation of bilious channels is carried out by means of branches of the neuroplex located in a liver. Blood arrives from a hepatic artery, outflow of blood is carried out in a portal vein. The lymph flows to lymph nodes that are in area of a portal vein.

Movement of bile in biliary tract happens at the expense of the secretory pressure which is carried out by a liver and also thanks to motor function of sphincters, a gall bladder and owing to a tone of walls of bilious channels.

Structure of bilious channels

Depending on dislocation channels are divided on extrahepatic (the left and right hepatic channels, hepatic the general, bilious the general and vesical channels belong here) and into intra hepatic. The hepatic bilious channel at the same time is formed thanks to merge two side (left and right) hepatic channels which take away bile from each hepatic share.

Puzyrny Canal, in turn, originates from a gall bladder, then, merging with the general hepatic, creates the general bilious. The last consists of 4 parts: supraduodenalny, retropancreatic, retroduodenal, intramural. Opening on a faterovy nipple of a duodenum, the intramural part of the general bilious canal forms the mouth where pancreatic and bilious channels combine in a so-called hepatopancreatic ampoule.

Diseases of bilious channels

Bilious ways are subject to various diseases, the most widespread of them are described below:

• Cholelithiasis. It is characteristic not only of a gall bladder, but also of channels. Morbid condition to which the persons inclined to completeness are most often subject. Consists in formation of stones in bilious channels and a bubble owing to stagnation of bile and at disturbance of exchange of some substances. The structure of stones is very various: it is mix of bile acids, bilirubin, cholesterol, etc. elements. Quite often stones in bilious channels do not bring notable discomfort to the patient why their carriage can be estimated for years. In other situations the stone is capable to cork bilious ways, to damage their walls that leads to emergence of an inflammation in bilious channels which is followed by hepatic gripes. Pain is localized in the area in right hypochondrium and gives to a back. Quite often is followed by vomiting, nausea, high temperature. Treatment of bilious channels at formation of stones quite often includes the diet based on the use of food, vitamin-rich A, K, D with the low calorie content and an exception of the products rich with animal fats;
• Dyskinesia. Often found disease at which motor function of bilious ways is broken. It is characterized by change of pressure of bile in various departments of a gall bladder and channels. Dyskinesia can be as independent diseases, and to accompany morbid conditions of bilious ways. Symptoms of dyskinesia are the heavy feeling and pain in a verkhnepravy zone of a stomach which arises later 2 h after meal. Also nausea, vomiting can be observed. Treatment of bilious channels at the dyskinesia caused by neurotization carry out by means of the funds allocated for treatment of neurosises (first of all a valerian root);
• Cholangitis or inflammation in bilious channels. It is in most cases observed at acute cholecystitis, however maybe by an independent disease. It is shown in the form of pains in the field of the right hypochondrium, fever, plentiful release of sweat, often is followed by attacks of nausea and vomiting. Quite often against the background of a cholangitis there is jaundice;
• Cholecystitis is acute. An inflammation in bilious channels and a gall bladder owing to hit of an infection. As well as gripes, is followed by pain in the field of the right hypochondrium, temperature increase (from subfebrile to high values). Besides, increase in a gall bladder in sizes is observed. As a rule, arises after plentiful acceptance of greasy food, alcohol intake;
• Cholangiocarcinoma or bile duct carcinoma. Intra hepatic, distal bilious channels, and also located in the field of hepatic gate are subject to cancer. As a rule, the risk of development of cancer increases at a chronic current of a number of diseases, including a cyst of biliary tract, stones in bilious channels, a cholangitis, etc. Symptoms of a disease are very various and fevers, vomitings and/or nausea and others can be shown in the form of jaundice, an itch in the field of channels. Treatment is performed by removal of bilious channels (if the size of a tumor is limited by an internal gleam of channels), or if the tumor extended out of liver limits, removal of bilious channels with the struck part of a liver is recommended. At the same time transplantation of a liver of the donor is possible.

Methods of a research of bilious channels

Diagnosis of diseases of bilious ways is carried out by means of modern methods which descriptions are given below:

• intraoperative haledo-or holangioskopiya. Methods, reasonable when determining a choledochotomy;
• ultrasonic diagnosis with a high share of accuracy reveals existence of stones in bilious channels. Also the method helps to diagnose a condition of walls of bilious ways, their size, existence of concrements, etc.;
• duodenal sounding – a method which is used not only for diagnosis, but also in medical. It consists in introduction of the irritants (as a rule, parenterally) stimulating reductions of a gall bladder and weakening a sphincter of a bilious channel. Advance of the probe on a digestive tract causes allocation of a secret and bile. Assessment of their quality along with the bacteriological analysis give an idea of existence or absence of this or that disease. So, this method allows to study motor function of biliary tract, and also to reveal obstruction of bilious ways a stone.