The gallbladder is a pear-shaped sac lying on the visceral surface of the right lobe of the liver in a fossa between the right

and quadrate lobes.

Size: 10 x 4 cm (but depends on volume of bile)

Volume: 35-50 ml

Thickness: 1-2 mm

Parts

• Distal fundus: extends beyond anterior liver margin.

• Central body: most of gallbladder.

• Neck: narrows as it joins the cystic duct.

• Infundibulum: portion of body that joins the neck.

Gallbladder

Receives bile

Concentrates

Stores bile from the liver

And secret mucus

Vasculature cystic artery, usually

a branch of right hepatic artery.

Note: variations of bile ducts and arteries may be dangerous during surgery.

Embryology Develops with bile duct and

liver during week 4 as ventral bud (hepatic diverticulum) from caudal foregut .

Hepatic diverticulum has two components:

pars hepatica and pars cystica .Parts hepatica gives rise to

liver, common hepatic duct and intrahepatic bile ducts.

• Pars cystica gives rise to cystic diverticulum, which gives rise to gallbladder and cystic duct.

• Hepatic diverticulum elongates to form common bile duct.

• Above structures begin as solid cords, but at 8 weeks have lumina.

Congenital anomalies- Gallbladder

Agenesis (absence)• Rare; 50% discovered at autopsy.• Usually no cystic duct either .• Associated with choledocholithiasis, duodenal

atresia and other congenital anomalies.

Hypoplasia• Associated with extrahepatic biliary atresia.

Micro gallbladder• Defined as less than 2-3 cm long, 0.5 -1.5 cm wide .• Associated with idiopathic neonatal hepatitis,

alpha-1-antitrypsin disease, cystic fibrosis.

Cysts• May begin as pseudodiverticula (Rokitansky-Aschoff

sinuses) with progressive occlusion of communication with gallbladder.

Diverticula

Heterotopia• Also called ectopia or choristoma .• Normal tissue in abnormal location.• Includes liver parenchymal nodules, usually 2.5 cm

or less, suspended to gallbladder by mesenteric stalk.

Hourglass gallbladder

• Divided by central constriction.

Wandering gallbladder/ Floating gall bladder

• Long mesentery or no firm attachment to liver.

• At risk for torsion.

Abnormal positions

• Left sided (with or without situs inversus)

• intrahepatic

• retroperitoneal

• suprahepatic

• also within falciform ligament, lesser sac or abdominal wall.

Phrygian cap

• Inversion of distal fundus into body, to which it may become adherent.

• Either anatomic variant or acquired abnormality.

• Present in 5% of cholecystograms.

Double gall bladder

Absence of the cystic duct

Low insertion of the cystic duct

An accessory cholecystohepatic duct