EXCRETORY APPARATUS OF THE LIVER. 385 



The hepatic duct, formed by the union of a right and left branch, 

 which issue from the bottom of the transverse fissure and unite at a 

 very obtuse angle, descends to the right, within the gastro-hepatic 

 omentum, in front of the vena portse, and with the hepatic artery to 

 its left. Its diameter is about two lines, and its length nearly 'two 

 inches. At its lower end it meets with the cystic duct, descending' from 

 the gall-bladder ; and the two ducts uniting together at an acute angle, 

 form the common bile-duct. 



The gall-bladder (fig. 273, 20) is a pear-shaped membranous sac, 

 3 or 4 inches long, about an inch and a half across its Avidest part, 

 and capable of containing from 8 to 12 fluid-drachms. It is lodged 

 obliquely in a fossa on the under surface of the right lobe, with its large 

 end or fimdiis (21), yvliich projects beyond the anterior border of the 

 liver, directed downwards, forwards, and to the right, whilst its necJc 

 (■2-2), is inclined in the opposite direction. The gall-bladder is attached 

 above to the liver by areolar tissue and vessels, along the fossa formed 

 between the quadrate lobe and the remainder of the right lobe. Below, 

 it is free and covei-ed by the peritoneum, which is here reflected fi'om 

 the liver, so as to support the gall-bladder. Sometimes, however, the 

 peritoneum completely surrounds the latter, which is then suspended at 

 a little distance from the under surface of the liver. The fundus, 

 which is free, projecting, and always covered with peritoneum, touches 

 the abdominal parietes immediately beneath the margin of the thorax, 

 opposite the tip of the tenth costal cartilage. Below, the gall-bladder 

 rests on the commencement of the transverse colon ; and, farther back, 

 is in contact with the duodenum, and sometimes with the pyloric 

 extremity of the stomach. The neck, gradually narrowing, forms two 

 curves upon itself like the letter S, and then, becoming much con- 

 stricted, and changing its general direction altogether, it bends down- 

 wards and terminates in the cystic duct. 



The gall-bladder is supplied with blood by the cyslic branch of the 

 right division of the hepatic artery, along which vessel it also receives 

 nerves from the cocliac plexus. The cystic veins empty themselves into 

 the vena portie. 



The cystic duct is about an inch and a half in length. It runs 

 downwards and to the left, and unites with the hepatic duct to form 

 the common bile-duct. 



The common bile-duct, ductus communis clioledoclius, the largest of 

 the ducts, being from two to three lines in width, and nearly three 

 inches in length, conveys the bile from the liver and the gall-bladder 

 into the duodenum. It passes downwards and backwards, continuing the 

 course of the hepatic duct, between the layers of the gastro-hepatic 

 omentum, in front of the vena ports, and to the right of the hepatic 

 artery. Passing behind the first part of the duodenum it reaches the 

 descending portion and continues downwards on the inner and posterior 

 aspect of that part of the intestine, covered by or included in the head 

 of the pancreas, and, for a short distance, in contact with the right side 

 of the ])ancreatic duct. Together with that duct, it then perforates the 

 muscular wall of the intestine, and, after running obliquely for three 

 quarters of an inch between its coats, and forming an elevation 

 beneath the mucous membrane, it becomes somewhat constricted, and 

 opens by a common orifice with the pancreatic duct on the inner surface 

 of the duodenum, near the junction of the second and third portions of 



