Where is Your Gall Bladder?

In vertebrates the gallbladder (cholecyst, gall bladder, biliary vesicle) is a small organ that aids mainly in fat digestion and concentrates bile produced by the liver. In humans, the loss of the gallbladder is, in most cases, easily tolerated. The surgical removal of the gallbladder is called a cholecystectomy.

The gallbladder is a hollow system that sits just beneath the liver. 2 In adults, the gallbladder measures approximately 8 centimetres (3.1 in) in length and 4 centimetres (1.6 in) in diameter when fully distended. 3 It is divided into three sections: fundus, body, and neck.

The neck tapers and connects to the biliary tree via the cystic duct, which then joins the common hepatic duct to become the common bile duct. At the neck of the gallbladder is a mucosal fold called Hartmann's pouch, where gallstones commonly get stuck. The angle of the gallbladder is located between the costal margin and the lateral margin of the rectus abdominis muscle.

Gallbladder gross anatomy and local ducts connecting to the liver, pancreas and duodenum of the small intestine. Unlike elsewhere in the intestinal tract, the gallbladder does not have a muscularis mucosae. Micrograph of a normal gallbladder wall.

When food containing fat enters the digestive tract, it stimulates the secretion of cholecystokinin (CCK). In response to CCK, the adult human gallbladder, which stores about 50 millilitres (1.7 U.S. fl oz; 1.8 imp fl oz) of bile, releases its contents into the duodenum. The bile, originally produced in the liver, emulsifies fats in partly digested food.

During storage in the gallbladder, bile becomes more concentrated which increases its potency and intensifies its effect on fats. In 2009, it was proposed that the gallbladder can produce several pancreatic hormones, including insulin. Most vertebrates have gallbladders, whereas invertebrates do not.

However, its precise form and the arrangement of the bile ducts may vary considerably. In many species, for example, there are several separate ducts running to the intestine, rather than a single common bile duct, as in humans. Several species of mammals (including horses, deer, rats, and various lamoids6) and several species of birds lack a gallbladder altogether, as do lampreys.

Diagram of Human Stomach and Gallbladder – Human Anatomy Online, MyHealthScore.com. Www.newchronicles.webs.com/f/gastrointestinalphysiology – Gastrointestinal Physiology Review.

The present study reviewed the occurrence of gall bladder carcinoma in patients who underwent a cholecystectomy for gallstone disease. A retrospective study of demographical and clinical information for patients who underwent a cholecystectomy and operative cholangiogram for gallstones predominantly in three major hospitals located in the northern area of Melbourne was carried out. Gall bladder carcinomas were observed in 14 patients (3.2%; 95% confidence interval (CI): 1.8-5.3%) consisting of 11 women and three men of median age 78.5 years (interquartile range: 77-81) from a series of 439 patients with a male-to-female ratio of 1-2.

The results of the present study show that primary carcinoma of the gall bladder in this descriptive retrospective cohort was always associated with single or multiple cholesterol gallstones that were impacting on the gall bladder wall. Cholesterol 'solitaire' gallstones were ovoid in shape with diameters > 3 cm along their longest axis, whereas multiple cholesterol gallstones varied in size and number from two or three large stones (1-2 cm), to numerous smaller stones (variable size to 0.5 cm). No patient with gall bladder carcinoma had either brown or black pigment gallstones.

It is postulated that gall bladder carcinoma may be intimately associated with large or numerous cholesterol gallstones that in the first instance may interfere with the mechanical functioning of the gall bladder. The size as well as the number of gallstones present in the gall bladder may contribute significantly to the promotion of a gallstone filling defect of the gall bladder that may cause chronic mechanical damage to the gall bladder mucosa. The present report supports the hypothesis that gall bladder carcinoma is an age-dependent malignancy, present mostly in women, that may be intimately associated with long-standing benign gallstone disease of the gall bladder.