Anyone knows where the liver is located, about its role in the physiology of a living organism. But where is the choledochus, what is it? Not everyone knows this. The accessory organ of digestion is the gallbladder. Its narrowest part (the neck) passes into the cystic duct and merges with the hepatic duct. Formed ducts choledochus common bile duct, or simply speaking, common bile duct.
It runs along the outer edge of the liver, between the peritoneal sheets in the area of the hepatoduodenal ligament, going down between the head of the pancreas and the duodenum (12PC). Then it passes from the inside, through the back wall of the 12PC and flows into the intestinal lumen in the region of the veterinary papilla.
Physiological parameters and structure of the common bile duct
Choledochus also 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 confluence of the cystic duct. If the hepatic duct is elongated, the choledochus will be shorter. What does it mean? Only that the length of the duct is individual. The diameter changes from larger to smaller along the way. At the beginning, it is 5-8 mm. Then a change in the lumen is observed, and at the point of entry into 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 growth of connective tissue, choledoch can thicken up to 3-4 mm.
The common bile duct consists of 4 sections.
- Supraduodenal. Length - up to 4 cm.
- Retroduodenal. Length - 1-2 cm. Passes retroperitoneally 12 PCs before touching the pancreas.
- Pancreatic. Length - 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 the dilatation of the choledochus. Dilatation from the Latin dilatation - expansion of the lumen of the duct. Occurs due to the mechanical narrowing of the lower part of the organ.
Causes of dilation:
- Congenital and acquired malformations (hypoplasia, cysts).
- Benign diseases of the gallbladder (cholelithiasis, strictures of the bile ducts).
- Inflammatory processes (cholecystitis, cholangitis, pancreatitis).
There are a number of legitimate questions. How does this change the choledochus? What might this entail? In such cases, a number of clinical trials are assigned toestablishing the cause of changes in the lumen and choosing a method for further treatment.
Survey methods
The most common and reliable method of examining the liver is ultrasound. Modern ultrasound machines allow you to get a clear picture of the state of the hepatic ducts. Unfortunately, small calculi in the common duct are often not visualized by ultrasound. In such cases, it is necessary to resort to other diagnostic methods in order to examine the entire choledochus. What are these methods?
- Contrast X-ray.
- Methods of direct contrast (duodenoscopy with catheterization, puncture of the common bile duct 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 is impossible not to note the importance of general and biochemical blood tests. These studies allow us to talk about 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 gallbladder. What causes liver disease? The root cause is always lifestyle and nutrition, frequent drinking, smoking. The love of fatty, fried foods also plays a role, as does the uncontrolled, unjustified use of medicines. Sometimes problems are caused by the innate characteristics of a person. Sooner or later, this leads to the occurrence of inflammatory processes, the formation of stones. Blockage and expansion of the common bile duct begins. If pathological processes are asymptomatic, the situation worsens and leads to serious consequences, up to pancreonecrosis.
Treatment methods
Treatment should be comprehensive. If the underlying cause is the presence of stones in the common bile duct, the focus of treatment is often reduced to surgery. The possibilities of modern medicine allow the use of methods for reconstructing damage to the common bile duct, less traumatic surgical interventions.
In case of parasitic and inflammatory diseases, antibiotic therapy and duodenal sounding are carried out, aimed at releasing the common bile duct from congestion. The most effective method is prevention. He althy food, reasonable physical activity, timely preventive medical examination will help to maintain good physical shape for many years.
