Bile ducts
Bile ducts. general characteristics
Bile ducts are a system of channels designed to drain bile into the duodenum from the gallbladder and liver. The innervation of the bile ducts is carried out using the branches of the nerve plexus, located in the liver. Blood comes from the hepatic artery, the outflow of blood is carried out into the portal vein. Lymph flows to the lymph nodes in the portal vein.
The movement of bile in the biliary tract occurs due to secretory pressure exerted by the liver, as well as due to the motor function of the sphincters, the gallbladder and due to the tone of the walls of the bile ducts themselves.
The structure of the bile ducts
Depending on the dislocation, the ducts are divided into extrahepatic (this includes the left and right hepatic ducts, hepatic common, common bile and cystic ducts) and intrahepatic. In this case, the hepatic bile duct is formed by the fusion of two lateral (left and right) hepatic ducts, which drain bile from each hepatic lobe.
The cystic duct, in turn, originates from the gallbladder, then, merging with the common hepatic duct, forms a common bile. The latter consists of 4 parts: supraduodenal, retropancreatic, retroduodenal, intramural. Opening on the duodenal nipple of Vater, the intramural part of the common bile duct forms the mouth, where the pancreatic and bile ducts are combined into the so-called hepato-pancreatic ampulla.
Diseases of the bile ducts
The biliary tract is susceptible to various diseases, the most common of them are described below:
- Cholelithiasis. It is characteristic not only of the gallbladder, but also of the ducts. A pathological condition that most often affects persons prone to overweight. It consists in the formation of stones in the bile ducts and bladder due to stagnation of bile and metabolic disorders of certain substances. The composition of stones is very diverse: it is a mixture of bile acids, bilirubin, cholesterol and other elements. Quite often stones in the bile ducts do not cause significant discomfort to the patient, which is why their carriage can be calculated for years. In other situations, the stone is able to clog the bile ducts, damage their walls, which leads to inflammation in the bile ducts, which is accompanied by hepatic colic. The pain is localized in the area in the right hypochondrium and radiates to the back. It is often accompanied by vomiting, nausea, high fever. Treatment of bile duct stones for stone formation often includes a diet rich in vitamins A, K, D, low in calories and excluding foods rich in animal fats;
- Dyskinesia. A common disease in which the motor function of the biliary tract is impaired. It is characterized by a change in bile pressure in different parts of the gallbladder and ducts. Dyskinesias can be both independent diseases and accompany pathological conditions of the biliary tract. Symptoms of dyskinesia are a feeling of heaviness and pain in the upper right abdomen, which occurs 2 hours after eating. Nausea and vomiting may also occur. Treatment of the bile ducts with dyskinesia caused by neurotization is carried out with the help of funds aimed at treating neuroses (primarily valerian root);
- Cholangitis or inflammation in the bile ducts. In most cases, it is observed in acute cholecystitis, but it can also be an independent disease. It manifests itself in the form of pain in the right hypochondrium, fever, profuse sweating, often accompanied by attacks of nausea and vomiting. Often, jaundice occurs against the background of cholangitis;
- Acute cholecystitis. Inflammation in the bile ducts and gallbladder due to infection. Just like colic, it is accompanied by pain in the right hypochondrium, fever (from subfebrile to high values). In addition, there is an increase in the size of the gallbladder. As a rule, it occurs after an abundant intake of fatty foods, alcohol consumption;
- Cholangiocarcinoma or bile duct cancer. Intrahepatic, distal bile ducts, as well as those located in the area of the hepatic hilum, are susceptible to cancer. As a rule, the risk of developing cancer increases with the chronic course of a number of diseases, including a cyst of the biliary tract, stones in the bile ducts, cholangitis, etc. Symptoms of the disease are very diverse and can manifest themselves in the form of jaundice, itching in the area of the ducts, fever, vomiting and / or nausea and others. Treatment is carried out by removing the bile ducts (if the size of the tumor is limited by the internal lumen of the ducts), or if the tumor has spread outside the liver, it is recommended to remove the bile ducts with the affected part of the liver. In this case, donor liver transplantation is possible.
Methods for examining the bile ducts
Diagnosis of diseases of the biliary tract is carried out using modern methods, the descriptions of which are presented below:
- intraoperative haledo- or cholangioscopy. Methods appropriate in determining choledochotomy;
- ultrasound diagnostics with a high degree of accuracy reveals the presence of stones in the bile ducts. Also, the method helps to diagnose the condition of the walls of the biliary tract, their size, the presence of calculi, etc.;
- duodenal intubation is a method that is used not only for diagnostic purposes, but also for medical purposes. It consists in the introduction of stimuli (usually parenteral) that stimulate contraction of the gallbladder and relax the sphincter of the bile duct. The advancement of the probe along the digestive tract causes the release of secretions and bile. An assessment of their quality, along with bacteriological analysis, gives an idea of the presence or absence of a particular disease. So, this method allows you to study the motor function of the biliary tract, as well as identify blockage of the biliary tract by a stone.
Odeston is a drug for the TREATMENT of most diseases of the biliary system, because acts pointwise in 3 directions: firstly, it increases the formation and secretion of bile without stimulating contraction of the gallbladder, therefore it is safe even for patients with stones in the gallbladder, and secondly, it has a selective (targeted) antispasmodic effect directed only on the biliary tract and, finally, it reduces the stagnation of bile, prevents the crystallization of cholesterol and the formation of gallstones. Thus, Odeston helps to restore normal bile circulation, and therefore, helps to improve digestion.
Odeston is indicated for the treatment of diseases of the gallbladder and biliary tract, including cholelithiasis (cholelithiasis).
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