Pathology 3500 Lecture Notes - Lecture 28: Common Bile Duct, Common Hepatic Duct, Hepatic Veins
1 May 2018
School
Department
Course
Professor
Hepatobiliary DIsease
Lecture Outcomes
Anatomy
● 1200-1500g
● 2 main lobes (left and right)
● Dual blood supply
○ Oxygenated blood from hepatic artery
○ Portal vein
■ Deoxygenated blood that passed through the GI tract
■ How the ingested drugs get into the liver
● Bile duct
○ One from each of the lobes (left and right hepatic duct)
■ Joins the common hepatic duct
○ Joins into the common bile duct
● Gallbladder
○ Cystic duct
○ Stores bile
● Hiesters spiral valve
○ Allows bile to flow in both direction (in and out of the gallbladder)
● Common bile duct joins the pancreatic duct and ejects into the duodenum
Histology
● Divided into hexagonal lobules
○ At the centre of each lobule is the central ven
■ Joins the hepatic vein -> inferior vena cava -> heart
○ At the periphery of the lobule are the portal veins
■ Hepatic artery, portal vein and bile duct
○ The lobule consists of anastomosing sheets or cords of liver cells and comprised
of the
Function
● Metabolic
○ Glucose and lipid physiology
● Synthetic
○ Most serum proteins but not immunoglobulin
■ Albumin (maintains osmotic pressure)
■ Clotting factors
● Storage
○ Glycogen, triglycerides, ion, copper and lipid-soluble vitamins
■ Iron and copper are 2 of the major adult storage disorders
● Catabolic
○ Endogenous
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■ Hormones and serum proteins
○ Exogenous
■ Drugs
● Excretory
○ Bile
■ important for fat absorption
Diagnosing liver disease
● Liver function tests
○ Blood tests: Is the liver clearing toxins and produces proteins and clotting
factors?
■ Check the levels of Bilirubin, Albumin, INR
○ Liver enzyme tests: Is there liver cell inflammation?
■ ALT, AST, GGT, LDH
○ Liver ultrasounds: Is there a mass in the liver?
○ Liver biopsy: what is the microscopic appearance of the liver/liver lesion?
● Many liver diseases can be diagnosed by blood tests, so what is the role of biopsy?
○ Is there chronic hepatitis?
■ Person will be at risk for selorsis (put on list for liver transplant)
○ What is the degree of inflammation?
■ GRADE
○ How advanced is the disease?
■ How much fibrosis is there?
■ STAGE (I-IV)
Cirrhosis
● An end stage in the evolution of many chronic liver disease
● A diffuse disease
● Etiology
○ Infections
■ Hepatitis B and C
○ Drugs:
■ Alcohol
○ Metabolic:
■ Hemochromatosis
■ NAFLD
○ Autoimmune
■ PCB
■ AIH
○ Biliary obstruction
■ Cacilt
■ Scleosing choloangitis
○ Vascular conditions
○ Neonatal conditions
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Deoxygenated blood that passed through the gi tract. How the ingested drugs get into the liver. One from each of the lobes (left and right hepatic duct) Allows bile to flow in both direction (in and out of the gallbladder) Common bile duct joins the pancreatic duct and ejects into the duodenum. At the centre of each lobule is the central ven. Joins the hepatic vein -> inferior vena cava -> heart. At the periphery of the lobule are the portal veins. Hepatic artery, portal vein and bile duct. The lobule consists of anastomosing sheets or cords of liver cells and comprised of the. Glycogen, triglycerides, ion, copper and lipid-soluble vitamins. Iron and copper are 2 of the major adult storage disorders. Check the levels of bilirubin, albumin, inr. Person will be at risk for selorsis (put on list for liver transplant) An end stage in the evolution of many chronic liver disease.
