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Gallbladder Pathology Online

Physiology of the Gallbladder

Dr Sampurna Roy  MD  

 

Bile, as it leaves the liver, is composed of 97% water,  1 to 2 % of bile salts, and 1 % of pigments, cholesterol, and fatty acids.

The liver excretes bile at a constant rate, estimated at 40 ml per hour.

Except when active gastroduodenal digestion is in progress, the sphincter of Oddi contracts and consequently bile leaving the liver passes into the gall-bladder.

The healthy gall-bladder has several functions :

- Concentration of bile : By the active absorption of water, sodium, chloride, and bicarbonate by the mucous membrane of the gall-bladder into the bloodstream and to a lesser extent into the lymphatics, the hepatic bile which enter the gall-bladder becomes concentrated from 5 to 10 times, with a corresponding increase in the proportion of bile salts, bile pigments, cholesterol, and calcium it contains.

- Reservoir for bile :  Bile is stored until the gall-bladder is full, when the sphincter of Oddi partially relaxes and the overflow trickles into the duodenum.

Contraction of the gall bladder and synchronous relaxation of the sphincter of Oddi is stimulated by cholecystokinin, a hormone secreted by the duodenum in response to acid chyme, fats and egg yolk or magnesium sulphate in its lumen.

- Changing the reaction of the bile : The bile excreted by the liver is alkaline  (pH 8.2), whereas that in the gall bladder becomes acid (pH 7.6 to 7) as the bile becomes concentrated.

- Cholesterol excretion by the gall bladder: It has not been proved, but pathological evidence of the gall-bladder epithelium choked with crystalline cholesterol is suggestive that the gall-bladder may add cholesterol to the bile.

- Secretion of mucin : About 20 ml. is secreted each twenty-four hours.

 

 

 

 

 

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