Any person knows where the liver is about its role in the physiology of a living organism. But where is the common bile duct, what is it? Not everyone knows this. An auxiliary digestive organ is the gall bladder. Its narrowest part (neck) passes into the cystic duct and merges with the hepatic. The ducts choledochus forms the common bile duct, or simply put, choledoch.
It passes along the outer edge of the liver, between the peritoneal sheets in the area of the hepatoduodenal ligament, dropping down between the head of the pancreas and the duodenum (12PC). Then it passes from the inside, through the back wall of 12PCs and flows into the intestinal lumen in the region of the papilla papilla.
Physiological parameters and structure of the common bile duct
The common bile duct has certain physiological standards. The norm is represented by the following indicators: its length should be 2–12 cm. There is a dependence of this characteristic on the site of inflow of the cystic duct. If the hepatic duct is elongated, the common bile duct will be shorter. What does it mean? Only that the length of the duct is individual. The diameter changes from a larger indicator to a smaller one along the line. At the beginning it is 5-8 mm. Then there is a change in the lumen, and at the entrance to the intestine, the duct narrows to 3 mm. The wall thickness is from 0.5 to 1.5 mm. In pathological conditions due to the proliferation of connective tissue, the common bile duct can thicken up to 3-4 mm.
The common bile duct consists of 4 sections.
- Supraduodenal. The length is up to 4 cm. It passes along the outer edge of the hepato-duodenal ligament from the inflow of the cystic duct to the upper edge of 12PCs.
- Retroduodenal. The length is 1-2 cm. It passes retroperitoneally for 12PCs before touching the pancreas.
- Pancreatic. The length is up to 3 cm. It is in contact with the head of the pancreas and is surrounded by it.
- Intraduodenal. The length is 1-2 cm. It is located in the wall of 12PCs.
Pathological changes
There are a number of pathological changes in the common bile duct. One of them is dilation of the common bile duct. Dilatation from Latin dilatation - expansion of the lumen of the duct. Occurs in connection with the mechanical narrowing of the lower part of the organ.
Reasons for dilatation:
- Congenital and acquired malformations (hypoplasia, cysts).
- Benign diseases of the stomach (gallstone disease, strictures of the bile ducts).
- Inflammatory processes (cholecystitis, cholangitis, pancreatitis).
A number of logical questions arise. How does the common bile duct change? What could this entail? In such cases, a number of clinical studies are prescribed to determine the cause of lumen changes and to select a method for further treatment.
Survey methods
The most common and reliable method of examining the liver is ultrasound. Modern ultrasound machines provide a clear picture of the condition of the hepatic ducts. Unfortunately, small calculi in the common duct during ultrasound are often not visualized. In such cases, it is necessary to resort to other diagnostic methods in order to examine the entire common bile duct. What are these methods?
- Contrast x-ray examination.
- Direct contrast methods (duodenoscopy with catheterization, choledoch puncture under ultrasound control).
These methods make it possible to establish the cause of obstruction of the common duct more accurately and in hard to reach places.
It should be noted the importance of a general and biochemical blood test. These studies suggest the presence of inflammatory processes.
Causes of diseases of the gallbladder and common bile duct
Changes in the common bile duct indicate the existence of pathological processes in the liver and gall bladder. What causes liver disease? The root cause is always lifestyle and nutrition, frequent drinking, and smoking. The love of fatty, fried foods also plays a role, as does the uncontrolled, unjustified use of medications. Sometimes problems are caused by the innate features of a person. Sooner or later, this leads to the occurrence of inflammatory processes, the formation of stones. Clogging and expansion of the common bile duct begins. If pathological processes are asymptomatic, the situation is aggravated and leads to serious consequences, up to pancreatic necrosis.
Treatment methods
Treatment should be comprehensive. If the main reason is the presence of calculi in the common bile duct, the focus of treatment is often reduced to surgical intervention. The possibilities of modern medicine allow the use of methods for the reconstruction of damage to the common bile duct, less traumatic surgery.
In case of parasitic and inflammatory diseases, antibiotic therapy and duodenal sounding are carried out, aimed at releasing the common bile duct from congestive phenomena. The most effective method is prevention. Healthy food, reasonable physical activity, timely preventive medical examination will help maintain good physical shape for many years.