Gallbladder disorders: Clinical

The gallbladder is a small, pouch-like organ that stores the bile produced by the liver.

After a fatty meal, the gallbladder contracts and releases bile to help break down fats in the diet.

Bile is made up mostly of water, bile salts, bilirubin and fats, as well as cholesterol.

Now, the most common gallbladder diseases have to do with an imbalance in bile fluid composition, which leads to the formation of stones either in the gallbladder or somewhere along the biliary tree.

The biliary tree is made up of the left and right hepatic duct which come together and form the common hepatic duct, as well the cystic duct, which unites with the common hepatic duct to form the common bile duct, also known as choleducus duct.

Finally, the common bile duct joins with the main pancreatic canal to open in the second part of the duodenum.

Now, most gallbladder diseases are related to either the presence of stones in the gallbladder or in the common bile duct, and whether those locations are infected as the result of an obstruction caused by the gallstones.

A gallstone in the gallbladder is called cholelithiasis, and a gallstone in the common bile duct is called choledocolithiasis, and both are associated with mild inflammation. But, if the gallstones block the normal bile flow this can cause severe inflammation in the biliary tree.

When there’s a lot of inflammation, the gallbladder and common bile duct tissue becomes extremely susceptible to infection. An infection of an obstructed gallbladder is called cholecystitis, and an infection of an obstructed common bile duct is called cholangitis, or ascending cholangitis.

In cholelithiasis, gallstones often develop from an imbalance in bile composition.

For example, if there’s too much cholesterol, cholesterol gallstones form, and that happens mostly in female individuals during the reproductive period, especially over the age of forty. Other risk factors include being overweight and native American.

If, however, the bile has too much bilirubin, pigment gallstones form, and this happens with hemolysis, liver cirrhosis, and sickle cell anemia.