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ANALYTICAL LITERATURE REVIEW) DOI: 10.36740/Wlek202005131 Wiadomości Lekarskie, VOLUME LXXIII, ISSUE 5, MAY 2020 © Aluna Publishing REVIEW ARTICLE SPECIFICITY OF MORPHOFUNCTIONAL STRUCTURE OF THE HUMAN AND ANIMAL BILIARY SYSTEM (ANALYTICAL LITERATURE REVIEW) DOI: 10.36740/WLek202005131 Olena B. Riabushko UKRAINIAN MEDICAL STOMATOLOGICAL ACADEMY, POLTAVA, UKRAINE ABSTRACT The aim of the paper was the study of the structure of the basic parts of the gallbladder wall of humans and animals of different classes in a comparatively anatomical aspect using the bibliographic analysis of literature sources. Materials and methods: of the study was the contemporary publications on the anatomical and histological structure of the human and animal gallbladder wall mucosa, studied using the analysis, synthesis and summarizing of the obtained information. Conclusions: Basically, the structure of the gallbladder wall mucosa in humans and animals of different classes has much in common; however there are also significant differences depending on the natural type of nutrition. Structural organization of the gallbladder wall in animals in comparison with humans has individual features and depends on the type of nutrition. KEY WORDS: gallbladder, wall structure, bile ducts, types of nutrition Wiad Lek. 2020;73(5):1004-1010 INTRODUCTION MATERIALS AND METHODS Currently, the issues on the gallbladder and biliary system The present bibliographic analysis is based on published pathology are relevant. The most common diseases include peer-reviewed articles, books, manuals, monographs, ab- functional disorders of the gallbladder and sphincter of stracts of dissertations. For the purposes of the systematic Oddi, chronic cholecystitis and cholangitis, gallbladder review, the search for literature sources (related to the study cholesterosis, cholelithiasis, post-cholecystectomy syn- of the anatomical and histological structure of the gallbladder drome. Cholelithiasis ranks third after cardiovascular wall mucosa in humans and animals of different classes) was disease and diabetes mellitus and is one of the most com- carried out using the Internet, domestic sources of scientific mon human pathologies. In the economically developed literature, the Scientific Library and eLibrary of the Ukrainian countries, the number of patients increases twice every Medical Stomatological Academy by the key words: “gallblad- ten years. In women, this pathology occurs 3-4 times der”, “wall structure”, “bile ducts”, “types of nutrition”. more often than in male population. There is an increase The search period covered the period from 2006 to 2017, in the incidence rate with age. Publications report that but some of the valuable data of earlier years is included in the increase in the incidence of biliary system diseases the review, as these literature sources are of considerable is caused by the environmental factors (dietary habits, scientific value. quality of food and water, type of nutrition, lifestyle) and The author used the following inclusion and exclusion endogenous factors. Therefore, the study of morphological criteria: features of the animal gallbladder wall, depending on the - inclusion criteria: original articles published in journals type of nutrition (herbivorous, carnivorous, omnivorous) and conference materials, books, manuals, monographs, is a topical problem, the solution of which will help in abstracts of dissertations, peer-reviewed, language of the choice of more effective treatment and methods of publication: Ukrainian, Russian, English; prevention [1, 2, 3]. - exclusion criteria: reviews, case studies, editorials, letters, and other non-peer reviewed publications, language of publication: other. THE AIM The study was aimed at the analysis of the structure of the basic parts of the gallbladder wall of humans and animals REVIEW AND DISCUSSION of different classes in a comparatively anatomical aspect The major function of the digestive system is to enable depending on the type of nutrition. the absorption of substances that come from the external 1004 SPECIFICITY OF MORPHOFUNCTIONAL STRUCTURE OF THE HUMAN AND ANIMAL BILIARY SYSTEM... environment to ensure plastic and energy metabolism. the neck, the mucous membrane contains alveolar-tubu- Hepatobiliary system is crucial in the processes of break- lar glands that secrete mucus. Less number of the above down and digestion of organic matter. It is known that the glands is found in the wall of the fundus and body of the gallbladder in the system of bile ducts performs several gallbladder. The initial portions of the glands consist of functions: storage and concentration of the bile, passage of glandular lobules separated by the connective tissue, and bile to the duodenum, regulation of pressure in the main the excretory ducts are S-shaped. The mucus of the alve- bile ducts, serves as a buffer reservoir of bile. olar-tubular glands protects the mucous membrane from The gallbladder vesica( biliaris) is located in the gallblad- aggressive exposure to bile. The inflammatory processes of der fossa on the visceral surface of the liver and adheres to the gallbladder cause excessive mucus secretion with a high the liver and leaf of peritoneum. Normally, the gallbladder content of mucin, which leads to altered reabsorption of sits in the longitudinal groove of the inferior surface of the water and electrolytes and causes bile secretion regulation liver, so that 2/3 of its surface is covered by the peritoneum, disorder. Altered physicochemical properties and biochem- and 1/3 is adjacent to the liver. In relation to the perito- ical structure of bile (dyscholia) are one of the factors for neum the gallbladder is located mesoperitoneally, retro- the formation of gallstones [2, 5, 7, 8] peritoneally and intramurally. In some cases, it is located The covering epithelium of the mucous membrane is intraperitoneally and has a very developed mesentery that directly involved in the processes of reabsorption of water allows it to rotate at 1800°, 3600°, 7200°, and 14400°. The and several other components; consequently, bile in the capacity of the gallbladder is usually 40-70 ml, measuring gallbladder differs from bile in the hepatic ducts, having a 8-14 cm in length and 3-5 cm in width. On the abdominal thicker texture and a darker color. The mucous membrane surface the wall thickness is from 30 to 3340 µm and the of the bile ducts is formed by a layer of columnar epithe- wall thickness on the liver surface ranges from 230 to 1500 liocytes and lamina propria of the mucous membrane, µm. Most often the human gallbladder has a pear-shaped made by connective tissue. Epitheliocytes contain many (63%) and cylindrical (32%) forms, sometimes oval, bul- lysosomes and bile pigments spots. Epithelium contains bous and sac-like forms (together about 5%). The gallblad- small number of goblet cells, which number increases with der is divided into the fundus (fundus vesicae biliaris), the the development of inflammatory diseases of the bile ducts. body (corpus vesicae biliaris) and the neck (collum vesicae The common bile duct is lined by the mucous membrane biliaris). The fundus is the widest part, facing anteriorly, of the common bile duct, which is formed by the simple that reaches the front edge of the liver, and sometimes lies columnar epithelium of the common bile duct and contains behind it; the body is the middle part that lies between the the glands of the common bile duct [2, 7, 8]. fundus and the neck; the neck is the narrowed part of the The muscular layer of the gallbladder is formed by the gallbladder, which is directed posteriorly and tapers into bundles of smooth muscular fibers, run in circular di- cystic duct. It continuous to the liver hilum and together rection and arranged in the form of the net. Bundles of with the cystic duct lies in the hepatic-duodenal junction. myocytes are separated by loose connective tissue. The The cystic duct has a diameter of 0.2-0.7 cm and a length structure of the muscular layer is adapted to the function of 1-7 cm. The angle of confluence of the cystic and com- of the buffer reservoir of bile. When the bile passage is mon bile ducts is 22-41°. At a junction, where the common obstructed by the common bile duct, there is a passive hepatic duct (ductus hepaticus communis) unites with the increase in the capacity of the gallbladder without bile duct cystic duct (ductus cysticus) the common bile duct (ductus dilatation. The muscular tunic of the bile duct is rather thin, choledochus) enters into the duodenum. The common bile formed by helical bundles of smooth myocytes containing duct continues via the hepatic and duodenal junction to a considerable amount of connective tissue. The muscular the left down and enters into the cavity of the duodenum. membrane is well developed in the wall of the cystic duct The length of the common bile duct is 5-8 cm with a di- when it unites with the gallbladder and in the wall of the ameter of 5-9 mm, but in some pathological conditions, common bile duct when it enters the duodenum. At the the choledoch can be distended up to 2-3 cm. Publications above sites, the bundles of the smooth myocytes form report about the high variability of the anatomical features sphincter muscles. In the distal parts of the cystic duct, of topographic interposition and maldevelopment of the the sphincter of Lutkins is formed, and sphincter of Oddi elements of the biliary system [1, 4, 5, 6]. is formed at the point where common bile duct enters the It is known that the gallbladder wall is composed of three duodenum, regulating the processes of bile flow into the membranes: mucous (tunica mucosa), muscular (tunica duodenum. The connective tissue layer of the gallbladder muscularis) and adventitious or connective tissue (tunica (adventitia) is formed by a dense fibrous connective tissue adventitia). The cystic and common bile ducts have a simi- with numerous thick elastic fibers arranged in the form of a lar wall structure. The mucous membrane forms numerous net. The adventitious membrane of the bile ducts is formed folds and crypts, the deepest of which reach the muscular by a loose connective tissue [4, 7, 9].
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