Choledoch - what is this? Physiological indicators and pathological processes

Any person knows where the liver is located, about its role in the physiology of a living organism. But where is the holedoch, what is it? Not everyone knows this. The auxiliary organ of digestion is the gallbladder. The narrowest part (neck) passes into the cystic duct and merges with the hepatic duct. The ducts choledochus forms a common bile duct, or simply, holedoch.

It passes along the outer edge of the liver, between peritoneal sheets in the region of the hepatoduodenal ligament, sinking down between the head of the pancreas and the duodenum (12PK). Then it passes from the inside, through the back wall of the 12PK and poured into the lumen of the intestine in the region of the phachopic papilla.

Physiological indicators and structure of the common bile duct

Certain physiological standards have also holedoh. The norm is represented by the following indices: its length should be 2-12 cm. The dependence of this characteristic on the place of the confluence of the cystic duct is observed. If the hepatic duct is lengthened, the holedoch 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 in the course of travel. In the beginning it is 5-8 mm. Then a change in the lumen is observed, and at the entrance to the intestine the duct narrows to 3 mm. The thickness of the walls is from 0.5 to 1.5 mm. In pathological conditions due to proliferation of connective tissue holedoh can thicken to 3-4 mm.

The common bile duct consists of 4 parts.

1. Supraduodenal. The length is up to 4 cm. Passes along the outer edge of the hepatic duodenal ligament from the region of the confluence of the cystic duct to the upper edge of the 12PK.
2. Retroduodenal. The length is 1-2 cm. It passes retroperitone in 12PK before touching the pancreas.
3. Pancreatic. The length is up to 3 cm. It contacts the head of the pancreas and is surrounded by it.
4. Intraduodenal. The length is 1-2 cm. It is located in the wall 12PK.

Pathological changes

There are a number of pathological changes in the common bile duct. One of them is the dilatation of choledoch. Dilation from Latin dilatation - dilatation of the lumen of the duct. Occurs in connection with the mechanical narrowing of the lower part of the organ.

Causes of dilation:

1. Congenital and acquired malformations (hypoplasia, cysts).
2. Benign diseases of the liver (gallstone disease, strictures of the bile ducts).
3. Inflammatory processes (cholecystitis, cholangitis, pancreatitis).

A number of legitimate questions arise. How does this change the cold? What can it entail? In such cases, a number of clinical studies are assigned to determine the cause of changes in the lumen and choose a method for further treatment.

Methods of examination

The most common and reliable method for examining the liver is ultrasound. Modern ultrasound machines can provide a clear picture of the state of the hepatic ducts. Unfortunately, concrements of small sizes in a common duct with ultrasound are often not visualized. In such cases it is necessary to resort to other methods of diagnosis in order to investigate all holedoch. What are these methods?

1. Contrast X-ray study.
2. Methods of direct contrasting (duodenoscopy with catheterization, choledochus puncture under ultrasound control).

These methods make it possible to establish the cause of the obstruction of the common duct more precisely and in hard-to-reach places.

It is necessary to note the importance of a general and biochemical analysis of blood. The given researches allow to speak about 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 a lifestyle and nutrition, frequent use of alcohol, smoking. Love for fatty, fried foods also plays a role, as is uncontrolled, unjustified use of medicines. Sometimes the problems are due to the innate characteristics of a person. Sooner or later, it leads to the emergence of inflammatory processes, the formation of stones. The obstruction and expansion of the choledocha begins. If pathological processes pass asymptomatically, the situation is aggravated and leads to serious consequences, up to pancreatonecrosis.

Methods of treatment

Treatment should be comprehensive. If the main cause is the presence of concretions in the common bile duct, the direction of treatment is often reduced to surgical intervention. The possibilities of modern medicine make it possible to use methods of reconstruction of the common bile duct injury, less traumatic surgical interventions.

With parasitic and inflammatory diseases, antibiotic therapy and duodenal sounding are conducted, aimed at releasing choledoch from stagnant phenomena. The most effective method is prevention. Healthy food, reasonable physical activity, timely preventive medical examination will help to maintain a good physical shape for many years.