THE LIVER 



1187 



Bile passages. — The bile passages, which transmit the bile from the liver to the 

 duodenum, include the gall-bladder, the cystic duct, the hepatic ducts, and the 

 common bile duct. 



The gall-bladder [vesica fellea], which retains the bile, is situated between the 

 right and quadrate lobes on the lower surface of the liver. It is pear-shaped, 

 and when full, is usually seen projecting beyond the anterior border of the liver, 

 coming in contact with the abdominal wall opposite the ninth costal cartilage at 

 the lateral margin of the right rectus muscle (fig. 914). It extends back as far as 

 the portal fissure. 



It measures in length, from before backward, 7 to 10 cm. It is 2.5 to 3.5 cm. 

 across at the widest part, and will hold about 35 cc. (U oz.). The broad end of the 

 sac is directed forward, downward, and to the right, and is called the fundus. 

 The narrow end, or neck [collum vesica fellese], which is curved first to the right, 

 then to the left, lies within the gastro-duodenal ligament at the portal fissure. 

 The intervening part is called the body [corpus vesicae fellesBJ. 



Fig. 948. — Diagram of the Portal Unit and Vascular Relations of the Hepatic Lobule . 



(After Szymonowicz.) 



PORTAL UNIT 



PORTAL UNIT 



Central 

 vein 



Central 

 vein 



Its upper surface is in contact with the liver, lying in the fossa of the gall-bladder. It is 

 attached to the liver by connective tissue. The lower surface is covered by peritoneum, which 

 passes over its sides and inferior surface, though occasionally it entirely surrounds the gall- 

 bladder, forming a sort of mesentery attaching to the liver. The lower surface comes into con- 

 tact with the first part of the duodenum and the transverse colon, and occasionally with the 

 pyloric end of the stomach or small intestine, which post mortem are often found stained with 

 bile. 



The neck of the gall-bladder opens into the cystic duct [ductus cysticus]. 

 This is a tube about 3.5 cm. long and 3 mm. wide, which unites with the hepatic 

 duct to form the ductus choledochus; it is directed backward and to the left as 

 it runs in the gastro-hepatic ligament, the common hepatic artery being to the left 

 and the right branch of the artery and portal vein behind. It joins the hepatic 

 duct at an acute angle, and is kept patent by a spiral valve [valvula spiralis; 

 Heisteri], formed by its mucous coat (fig. 949). 



The hepatic duct [ductus hepaticus] begins with a branch from each lobe, right 

 and left (that from the left receiving also the ducts from the caudate lobe), in 

 the portal fissure, and is directed downward and to the right within the portal 

 fissure and the hepato-duodenal ligament, the right branch of the hepatic artery 

 being behind and the left branch to the left. It is from 3 to 5 cm. long; its diame- 

 ter is about 4 mm. Uniting with the cystic duct, it forms the common hile-duct 

 [ductus choledochus]. 



