Gallbladder: the features of the structure and transport systems. Anatomy of bile ducts Common liver duct

The hepatic cells produce a day to 1 l bile coming into the intestines. Hepatic bile represents liquid yellow color, bubble bile more viscous, dark brown color with greenish tint. The bile is formed continuously, and its income in the intestine is associated with the meal. The bile consists of water, bile acids (glycochole, tautrochole) and bile pigments (bilirubin, biliverdine), cholesterol, lecithin, mucin and inorganic compounds (phosphorus, potassium salts and calcium, etc.). The value of bile in digestion is huge. First of all, bile, irritating the nerve receptors of the mucous membrane, causes peristaltics, holds fat in an emulsified state, which increases the field of influence of the enzyme lipase. Under the influence of the bile, the activity of lipase and proteolytic enzymes is increasing. Bile neutralizes chloride hydrochloric acid coming from the stomach, thereby preserving the activity of trypsin, and suppresses the action of pepsin gastric juice. Bile has bactericidal properties.

The biliary liver system should include biliary capillaries, septal and interdolt bile ducts, right and left hepatic, shared hepatic, bubble, shared bile ducts and gall-bubble.

The bile capillaries have a diameter of 1-2 μm, their lumens are limited to hepatic cells (Fig. 269). Thus, the hepatic cell is becoming a single plane towards the blood capillary, and the other - limits the gall capillary. The bile capillaries are located in the beams at a depth of 2/3 of the radius. From the bile capillaries, the bile arrives at the periphery of the slices in the surrounding septal bile ducts that merge into interdolt bile poles (Ductuli Interlobulares). They are connected to the right (1 cm long) and the left (2 cm long) hepatic duok (Ductuli Hepatici Dexter Et Sinister), and the latter merge into the overall liver duct. (2 - 3 cm long) (DUCTUS HEPATICUS Communis) (Fig. 270). It leaves the gate of the liver and connects with a bubble ductus (DUCTIC CYSTICUS) with a length of 3-4 cm. From the connection site of common liver and bubble ducts, a total bull duct (DUCTUS CHOLEDOCHUS) begins with a length of 5 - 8 cm, which flows into the duodenum. In his mouth there is a sphincter regulating the admission of bile from the liver and gallbladder.

269. The scheme of the structure of bile capillaries.
1 - hepatic cell; 2 - bile capillaries; 3 - sinusoids; 4 - interdolk bull duct; 5 - interdolk vein; 6 - interdelic artery.

270. Gallbladder and open bile ducts (by R. D. Sinelnikov).

1 - Ductus Cysticus;
2 - DUCTUS HEPATICUS Communis;
3 - Ductus Choledochus;
4 - Ductus Pancreaticus;
5 - AMPULLA HEPATOPANCREATICA;
6 - duodenum;
7 - Fundus Vesicae Fellae;
8 - Plicae Tunicae Mucosae Vesicae Fellae;
9 - Plica Spiralis;
10 - Collum Vesisae Fellae.

All ducts have an identical structure. They are seduced by cubic epithelium, and large proto-cylindrical epithelium. In large ducts, the connective layer is also expressed significantly better. In bile ducts there are practically no muscle elements, only in bubble and general bile ducts there are sphincters.

The gall bubble (Vesica Fellea) has an extended bag of 40-60 ml. In the bustling bubble there is a concentration of bile (6-10 times) by suction of water. The gallbladder is located in the front of the right longitudinal groove of the liver. Its wall consists of mucous membranes, muscular and connective tissue shells. Part of the wall facing abdominal cavitycovered with peritoneum. The bubble distinguishes the bottom, body and neck. The cervical cervix is \u200b\u200baddressed to the gate of the liver and together with the bubble duct in Lig. Hepatoduodenale.

Topography of the bubble and total bile duct. The bottom of the gallbladder comes into contact with parietal peritonean, projecting in the corner formed by the edge arc and the outer edge of the straight muscle of the abdomen or with intersection with the rib arc line connecting the top of the axillary fox with the navel. Bubble comes into contact with the transverse coloring intestine, pyloric part of the stomach and the top department duodenal gut.

The overall bull duct lies in the lateral part of Lig. Hepatoduodenale, where it can be easily palpable on the corpse or during surgery. The duct passes behind the upper part of the duodenum, selecting the right of the ductile vein or 3-4 cm from piloric sphincter, penetrating the head of the pancreas head; Its end of the final part inner wall descending part of the duodenum. In this part of the intestinal wall, the sphincter of the total bile duct is formed (m. Sphincter Ductus Choledochi).

Breast expense mechanism. Since bile in the liver is constantly produced, then in the period between the digestion, the sphincter of the total bile duct is reduced and bile enters the gallbladder, where it is concentrated by suction of water. During the digestion there comes a reduction in the wall of the gallbladder and relaxation of the sphincter of the total bile duct. The concentrated busty bubble is mixed with liquid hepatic bile and flows into the intestines.

Leaving the liver right and left liver ductures In the gate of the liver connect, forming a common liver duct, DUCTUS HEPATICUS Communis. Between the leaflets of the hepatic-duodenal bunch, the duct is descended by 2-3 cm down, to the connection site with a bubble duct. Behind him pass the right branch of its own hepatic artery (sometimes it passes the in front of the duct) and the right branch of the duty vein.

Bubble Dash, Ductus Cysticus, a diameter of 3-4 mm and a length of 2.5 to 5 cm, coming out of the neck of the gallbladder, heading to the left, flows into the overall liver duct. The angle of imposition and the distance from the neck of the gallbladder can be the most different. A spiral fold, PLICA spiralis, playing a certain role in the adjustment of bubble outflow from the gallbladder, isolated on the duct mucous membrane.

Common bull, DUCTUS CHOLEDOCHUS, is formed as a result of connecting common liver and bubble ducts. It is located first in the free right edge of the liver-duodenal bundle. On the left and several post from it there is a gala vein. The overall bull duct diversides bile in the duodenum. Its length averages 6-8 cm. Throughout the total bile duct, 4 parts are separated:

1) supradeodenal part general gallway It goes to a duodenalist in the right edge of Lig. Hepatoduodenale and has a length of 1-3 cm;
2) retroduodenal part general gallway A length of about 2 cm is located behind the upper horizontal part of the Duodenum approximately 3-4 cm. The right of the gastric gatekeeper. Above and to the left of it passes a gorgeous vein, below and right - a. gastroduodenalis;
3) pancreatic part general gallway Up to 3 cm long passes in the thickness of the pancreas head or behind it. In this case, the duct is adjacent to the right edge of the lower hollow vein. The gorgeous vein lies deeper and crosses the pancreatic part of the total bile duct in the oblique direction on the left;
4) interstitial, ultimate, part general gallway It has a length of up to 1.5 cm. The duct processes the rear-day wall of the middle third of the descending part of the duodenum in the oblique direction and opens on top of the large (fav) duodenal papilla, Papilla Duodeni Major. Pacifics located in the region of the longitudinal collar of the intestinal mucosa. Most often, the final part of the Ductus Choledochus merges with the pancreatic duct, forming when entering the intestine hepatic pancreatic ampoule, Ampulla Hepatopancreatica.

In the thickness of the wall of a large duodenal papilla, the ampoules surround smooth ring muscle fibers that form sphinteer of the Hepatic Pancreas Ampoule, m. Sphincter Ampullae Hepatopancreaticae.

Educational video anatomy of the gallbladder, bile ducts and triangle CALO

The bile ducts are a system of channels designed to remove bile in a duodenum of a gallbladder and a liver. Innervation of bile ducts is carried out using branches nervous plexuslocated in the liver area. Blood comes from the hepatic artery, blood outflow is carried out in mortal vein. Lymph is subject to K. lymphatic nodalswhich are located in the area of \u200b\u200bthe duty vein.

The movement of bile in biliary tract occurs due to the secretory pressure carried out by the liver, and also due to the motor function of the sphincters, the gallbladder and due to the tone of the walls of the bile ducts themselves.

The structure of bile ducts

Depending on the dislocation, the duces are divided into extrahepatic (there are left and right hepatic ducts, hepatic overall, bile common and bubble ducts) and intrahepical. The hepatic biliary duct is formed by the merger of two side (left and right) hepatic ducts that are diverted from each hepatic fraction.

Bubble duct, in turn, originates from the gallbladder, then merging with shared hepatic, forms a common bull. The latter consists of 4 parts: supradoenal, retropancreatic, retroduodenal, intramural. Opening in the fare pacifier of the duodenum, the intramural part of the total bile duct forms mouth, where pancreatic and bile ducts are combined into the so-called hepatic pancreatic ampoule.

Diseases of bile duksov

Gallways are subject to various diseasesThe most common of them are described below:

• Cholelithiasis. Characteristic not only for the gallbladder, but also for ducts. Pathological conditionwhich is most often subject to persons prone to completeness. It consists in the formation of stones in bile ducts and bubble due to stagnation of bile and in violation of the exchange of some substances. The composition of the stones is very diverse: this is a mixture of bile acids, bilirubin, cholesterol, and other elements. Often, stones in bile ducts do not cause tangible discomfort to the patient, why their carriage can be calculated for years. In other situations, the stone is able to block the gallways, damage their walls, which leads to the occurrence of inflammation in bile ducts, which is accompanied by hepatic colic. Pain is localized in the area in the right hypochondrium and gives back. Often accompanied by vomiting, nausea, high temperatures. Treatment of bile ducts in the formation of stones, often includes a diet based on eating food rich in vitamins A, K, D, with low content calories and the exception of products rich in animal fats;
• Dyskinesia. A common disease in which motor function is disturbed bile paths. Characterized by changing the pressure of bile in different departments gallbladder and ducts. Discinesia can be both independent diseases and accompany the pathological conditions of the biliary tract. Symptoms of diskinesia are the feeling of gravity and pain in the upper right zone of the abdomen, which occurs after 2 hours after meals. Nausea can also be observed, vomiting. Treatment of bile ducts with dyskinesia caused by neuroticization, is carried out using funds aimed at treating neurosis (first of all Valerian root);
• Cholant or inflammation in bile ducts. In most cases, it is observed when acute cholecystitis, however, maybe an independent disease. Manifests itself in the form of pain in the field of right hypochondrium, fever, abundant allocation Pot, often accompanied by the attacks of nausea and vomiting. Often on the background of cholangitis, jaundice arises;
• Cholecystitis sharp. Inflammation in bile ducts and bustling bubble due to infection. Just as colic, accompanied by pain in the field of right hypochondrium, increase in temperature (from subfebrile to high values). In addition, there is an increase in the gallbladder in size. As a rule, it occurs after abundant adoption of oily food, alcohol consumption;
• Cholangiocarcinoma or bile duct cancer. Intrahranny, distal bile ducts, as well as arranged in the hepatic gate, are subject to cancer. As a rule, the risk of cancer development increases in the chronic course of a number of diseases, including the cyst of biliary tract, stones in bile ducts, cholangitis, etc. The symptoms of the disease are very diverse and can appear in the form of jaundice, itching in the region of ducts, fever, vomiting and / or nausea and other. The treatment is carried out by removing bile ducts (if the tumor size is limited by the inner lumen of the ducts), or if the tumor has spread beyond the liver, it is recommended to remove bile ducts with the affected part of the liver. At the same time, a donor liver transplantation is possible.

Methods for the study of bile ducts

Diagnosis of diseases of the biliary tract is carried out with the help of modern methods, the descriptions of which are presented below:

• intraoperative haledo- or cholangioscopy. Methods are appropriate when determining choledochotomy;
• ultrasound diagnosis with a high accuracy of accuracy reveals the presence of stones in bile ducts. Also, the method helps to diagnose the status of the walls of the biliary tract, their size, the presence of concrections, etc.;
• duodenal sensing is a method that is used not only for the purpose of diagnosis, but also in therapeutic. It is in the introduction of stimuli (usually parenteral), stimulating the reductions of the gallbladder and relaxing the sphincter of the bile duct. Protecting Probe Po digestive tract Causes the allocation of secret and bile. Assessing their quality along with bacteriological analysis give an idea of \u200b\u200bthe presence or absence of one or another disease. So, this method Allows you to study the motor function of biliary tract, as well as to identify the blockage of the biliary tracks by stone.

Grocery ducts are a complex transport highway for the liver secret. They go from the tank (gallbladder) to the intestinal cavity.

Grocery channels are an important transportation for the hepatic secretion, providing its outflow from the gallbladder and the liver to the duodenum. They have their own special structure and physiology. Diseases may affect not only the LDP itself, but also bile ducts. There are plenty of disorders that violate their functioning, but modern methods Monitoring allows diagnosing diseases and cure them.

The gallways are the accumulation of tubular tubular channels, according to which the evacuation of bile in the duodenum of the gallbladder occurs. The regulation of the muscle fibers in the walls of the ducts occurs under the action of pulses from the nervous plexus located in the field of the liver (right hypochondrium). The physiology of excitation of biliary tubules is easy: when the receptors of the duodenum are irritated under the action of the dietary masses, nerve cells Separate signals to nerve fibers. From them to muscle cells there is a reduction impulse, and the muscles of the biliary tract relaxes.

The movement of the secretion in biliary ducts occurs under the influence of pressure rendered by the liver shares - this is facilitated by the function of the sphincter, called the motor, LP and the tonic stress of the vessel walls. It feeds the tissue of bile ducts. Large hepatic artery, and the outflow of poor blood oxygen occurs in the system of the carrier veins.

Anatomy of bile duksov

The anatomy of joy's ways is quite confusing, because these tubular formations have small sizes, but gradually they merge, forming large channels. Depending on how the bile capillaries will be located, they are divided into extrahepatic (hepatic, common bull and bubble duct) and intrahep.

The beginning of the bubble duct is at the base of the gallbladder, which, as a tank, stores surplus secrets, then a fusion occurs with hepatic, shared channel is formed. The bubble duct coming out of the gallbladder is divided into four compartments: supradeodenal, retropancreatic, retroduodenal and intramural channels. Going at the base of the Pateraska duodenal duodenum, a portion of a large bile vessel forms a mouth where the liver and pancreatic channels are converted to the hepatic pancreative ampoule, which distinguishes a mixed secret.

The hepatic channel is formed as a result of the fusion of two side branches transporting bile from each part of the liver. Bubble and hepatic tubules will be included in one large vessel - a common bull duct (choledoch).

Large duodenal nipples

Speaking about the structure of biliary tract, it is impossible not to remember the small structure in which they will fall. Large duodenal ducts (DK) or nipple fare - hemispherical flatted elevation, located on the edge of the folds of the mucous layer at the bottom of the DC, 10-14 cm above it is a large gastric sphincter - a gatekeeper.

The dimensions of the nipple of the nipple range from 2 mm to 1.8-1.9 cm in height and 2-3 cm in width. This structure is formed by the merger of bile and pancreatic withdrawing paths (in 20% of cases they may not be connected and the ducts derived from the pancreas, open up slightly above).

An important element of a large duodenal duct is that regulates the receipt of a mixed secret from the bile and pancreatic juice into the cavity of the intestine, and it does not allow the intestinal content of the intestine to get into the biliary ways or pancreatic channels.

Pathology of biliary dokuks

There are many disorders of the functioning of biliary tract, they may arise separately or the disease will concern the gallbladder and its ducts. The main violations include such:

• blockage of biliary channels (gallway disease);
• dyskinesia;
• cholangitis;
• cholecystitis;
• new formation (cholangiocarcinoma).

Hepatocyte allocates bile consisting of water, dissolved bile acids and some waste of metabolism. Upon timely excretion of this, the secret from the tank all functions normally. If stagnation or too fast secretion is observed, bile acids begin to interact with minerals, bilirubin, creating deposits - stones. This problem is characteristic of a bubble and biliary tract. Major concrections climb the clearance of bile vessels, damaging them, because of what inflammation and severe pain arises.

Dyskinesia - Dysfunction of motor fibers of biliary ducts, at which there is a jump-shaped change in the pressure of the secrets on the walls of the vessels and the gully bubble. This condition is an independent disease (neurotic or anatomical origin) or accompanies other disorders, for example, inflammation. For diskinesia, the appearance of pain in the right hypochondrium a few hours after meals, nausea, and sometimes vomiting.

- Inflammation of the walls of biliary tract, can be a separate disorder or symptom of other disorders, such as cholecystitis. Manifests in a patient inflammatory process Fever, chills, abundant secretion of sweat, pain in the right hypochondrium, lack of appetite, nausea.

- Inflammatory process covering bubble and bile duct. Pathology has infectious origin. The disease occurs in acute formAnd if the patient does not receive timely and high-quality therapy, goes into chronic. Sometimes at permanent cholecystitis, it is necessary to remove the LP and part of its ducts, because pathology prevents the patient to live normally.

Neoplasms in the bustling bubble and biliary ducts (most often they arise in the area of \u200b\u200bKolado) are dangerous problem, especially if we are talking about malignant tumors. Rarely conducted medicia treatment, The main therapy is operational intervention.

Methods for the study of bile ducts

Methods diagnostic research bile pathways help to detect functional disorders, as well as track the appearance of neoplasms on the walls of the vessels. The main methods of diagnosis include such:

• duodenal probing;
• intraoperative choledo or cholangioscopy.

The ultrasound examination allows you to detect deposits in the bustling bubble and ducts, and also indicates a neoplasm in their walls.

- The method of diagnosing bile composition, in which the patient parenterally introduces an irritant, stimulating the reduction of the gallbladder. The method allows to detect a deviation in the composition of the hepatic secret, as well as the presence of infectious agents in it.

The structure of the ducts depends on the location of the liver; overall plan resembles a branched crown of wood, as in large vessels There are many small.

Grocery ducts - a transport highway for the hepatic secretion from its reservoir (gallbladder) into an intestinal cavity.

There are plenty of diseases that violate the functioning of the biliary tract, but modern research methods allow you to detect the problem and cure it.

In such cases, they prescribe medications or assign an operation to remove stones.

Location, Building and Functions

Small hepatic ducts will bring bile from the liver into its shared channel. The length of the common hepatic path is about 5 cm, the diameter is up to 5 mm. It is combined with a bubble duct, which has a length of about 3 cm and the width of the lumen is about 4 mm. The common gallway (cholell, ozha) begins on the place of the merger of extra-chopped ducts. It has 4 departments, the length of which in the amount reaches 8-12 cm, and leads in large nipples of the initial department thin gut (located between the stomach and a thick intestine).

Departments of the general bile duct distinguish with their location:

• over the 12-risen intestine - supraudenal;
• behind the upper segment of the 12-risen intestine - retroduodenal;
• between the descending part of the small intestine and the pancreas head - retropancreatic;
• kosovo runs through rear wall The intestines and opens in the fae the puffy - intramural.

Final parts of the ozhap and pancreatic duct together form an ampoule in the fava papilla. It is mixed with pancreatic juice and bile. The size of the ampoule is normal: width from 2 to 4 mm, length from 2 to 10 mm.

In some people, the final parts of the ducts do not form an ampoule in a large papilla, and are opened with two holes in the 12-point intestine. This is not a pathology, but a physiological feature.

General duct walls consist of two muscular layers, longitudinal and circular. Due to the thickening of the last layer, at a distance of 8-10 mm until the end of the overall bile duct is formed (locking valve). He and other sphincters of the hepatic pancreas ampoule do not allow bile to penetrate the intestines when there is no food in it, and also exclude the outflow of the bowel content.

The mucous membrane of the general flow is characterized by smoothness. It forms several folds only in the distal phater sheepskin. The submisient layer has glands that produce a protective mucus. The outer sheath of the bile duct is loose connect fabricwhich includes nerve endings and blood vessels.

Possible diseases and how they manifest

Diseases of the biliary tracks Therapist diagnoses more often than the stomach ulcer. The pathological process inside the biliary duct causes:

Risk group make up women. This is due to the fact that they are more often male suffer from hormonal imbalance and excess weight.

Burning

The obstruction of bile ducts is most often the result. To lead to obturation (closing of the lumen) can be a tumor, cyst, infection with worms, bacteria, inflammation of the walls of the channels.

A sign of the fact that the ducts are scored, is, pain in the right hypochondrium. When blocking the biliary channels, Cal acquires a gray-white color, and urine darkens.

Narrowing

The main cause of the narrowing (stricture) of the biliary channels is the operation of software or neoplasm (cyst, tumor) in the output channel. Operated area for a long time It remains inflamed, which leads to the swelling and narrowing the LDP. The pathological state is manifested by a subfebrile temperature, pain in the right side, lack of appetite.

Scars and ties

With sclerosing cholangitis, the bull duct is inflamed, which leads to the replacement of its walls by scar cloth. As a result, the duct falls out (tightened), which causes a violation of the outflow of the hepatic secret, its absorption in blood and stagnation in the bubble. The danger of this state is its asymptomatic development and subsequent death of the liver cells.

Eveny

Catarial cholangitis is one of the reasons why the walls of the biliary tract are sealed. The disease is characterized by hyperemia (overcrowding blood vessels), the swelling of the mucous membrane, the accumulation of leukocytes on the walls, peeling the epithelium. The disease is often accepted chronic flow. A person constantly feels discomfort in the right side, accompanied by nausea and vomiting.

LCB

The hepatic secretion in the bubble and violation of cholesterol metabolism leads to education. When, under the influence of drugs, they begin to leave the bubble through the bile ducts, then they make themselves to know the piercing-cutting pain in the right side.

The patient can not guess for a long time about the presence of the disease, that is, being a latent stone.

If the concretion is large, it is partially or completely overlaps the clearance of the gall canal. This condition causes a gallbladder spasm, which is accompanied by painful syndrome, nausea and vomiting.

Tumors and metastases

The elderly with a problem biliary system is often diagnosed with Klackin's tumor. Malignant neoplasm In 50% of cases, the overall biliary duct is striking. In the absence of treatment, the tumor metastasizes into regional lymph nodes and neighboring organs (liver, pancreas).

On early stage Pathology manifests itself pain in the right hypochondrium that gives to the shovel and neck.

Discinesia.

With Greek, this term means a traffic violation. In this case, the disease of the wall and ducts of the gallbladder are reduced inconsistently. The bile in the 12th pans comes either in excess, or in insufficient quantity. Negatively affects the process of digesting food and absorb nutrient elements by the body.

Inflammation

This is inflammation of bile ducts. Arises against the background of their blockage or infection of the hepatic secret pathogenic bacteria. Inflammation happens:

• Sharp. It occurs unexpectedly. During the attack yellowes the skin, appears headache, Colic to the right under the ribs, pain gives to the neck and shoulder area.
• Chronic. Keeps subfebrile temperature, weak pain appear on the right, sweeps top department belly.
• Sclerosing. It proceeds asymptomatic, then manifests itself with irreversible hepatic insufficiency.

Expansion

The extension of choledoch most often provokes a reinforced cutting of the walls of the bubble (hyperkinosis). Other reasons can be in blockage of the lumen of the common channel with a concrete or tumor, violation of the work of the sphincter. These factors lead to an increase in pressure in the biliary system and the expansion of its ducts both in the liver and outside the organ. For the presence of pathology indicates pain syndrome in the right hypochondrium.

Atresia

The term "biliary atresia" means that a person has been clogged or lacking biliary roads. The disease is diagnosed immediately after birth. In a sick child, the skin acquires the yellow-green tint, urine has the color of dark beer, feces - white and gray shade. In the absence of treatment, the duration of the baby is 1-1.5 years.

How diagnosed diseases of the ducts

To the question, how to check the condition of the biliary system, specialists modern clinic advise:

Treat the gallbladder and biliary channels should be comprehensively. Therapy is based on diet nutrition and reception drug addicts.

The diet of the patient directly depends on the type, degree and severity of the disease, diet with the disease of the gallbladder should be aimed at lowering the load on the liver and normalize bile outflow.

In difficult cases, surgical intervention is prescribed.

Operations on bile ducts

Operation is carried out in order to eliminate obstacles (scar tissue, tumor, cyst), which interferes with the outflow of the hepatic secret. For different diseases Applied miscellaneous methods Treatment:

• Stenting the bile duct - shown in the case of a narrowing of biliary tract. In the lumen of the channel insert the stent (elastic, thin plastic or metal tube), which restores its permeability.
• Praderi drainage - applied when creating anastomosis (artificial compound of organs) between the biliary duty and thin intestineTo eliminate the narrowing of the operated zone. Also used to maintain normal pressure In the overall bile path.
• Endoscopic papillosphincterotomy (EST) - non-surgical operation. Removal of stones from bile ducts using the probe.

Conservative therapy

Non-surgical treatment of biliary diseases includes such methods:

• . In warm form, fractionally (up to 7 times a day), you can use small portions. Degreased meat broth, mucous rubber porridge, steam protein omelet, souffle of fish and dietary meat.
• Antibiotics wide spectrum Actions - Tetracycline, Levomycetin.
• Antispasmodic tools - drootaverin, spasmalgon.
• - Holosas, Allohol.
• Vitamins of group B, vitamins C, A, K, E.

Additional measures

The inflammation of the bile ducts is most often the result of human lacking and incorrect nutrition. Therefore, in preventive purposes, it is necessary to ask yourself daily physical exercise (half-hour walking, cycling, morning gymnastics).

From the menu you need to exclude fat, roasted, sharp, strongly reduced the number of sweets. It is recommended to use products that are a source of dietary fiber (oatmeal, lentils, rice, cabbage, carrots, apples), which contributes fast purification The organism from bile pigments, toxins, excess cholesterol.

Literature

• Aliyev, M. A. The use of magnetic resonance cholangiopancratography with non-heroic damage to bile ducts / M.A. Aliyev, E.A. Akhmetov // Honey. Visualization. - 2003. - No. Z. - P. 13-18.
• Vasilyev, A. Yu. Diagnostic capabilities of magnetic resonance cholangiography in identifying diseases of the gallbladder and bile ducts // Role radiation diagnosis in multidisciplinary clinics / Ed. V. I. Amosova / A. Yu. Vasilyev, V. A. Warnikov. - St. Petersburg: Publishing House of SPbGMU, 2005. - P. 43-45.
• Dobrovolsky, A. A. Robotoacesed laparoscopic cholecystectomy // Surgery. Magazine them. N.I. Pirogova / A. A. Dobrovolsky, A. R. Belyavsky, N. A. Kolmachevsky, etc. - 2009. - № 6. - P. 70-71.
• Kulikovsky, V. F. Miniminvasive treatment methods complicated gallgamed disease // Modern problems Science and Education / V. F. Kulikovsky, A. A. Karpachev, A. L. Yarosh, A. V. Soloshenko. - 2012. - № 2.
• Majorova, E. M. Relationship of the anomalies of the gallbladder and biliary tract with clinical picture cholecystitis: dissertation for the educational degree of the candidate medical Sciences / Goudpo Kazan State medical Academy. Kazan, 2008.
• Malakhova, E. V. Functional diseases of the gallbladder: perception of pain and features of psycho-emotional state: thesis on the competition for the educational degree of candidate of medical sciences / Goudpo Medical Academy of Postgraduate Education federal Agency Healthcare I. social Development. Moscow, 2006.