The human gallbladder
Abstract
The human gallbladder (vesica fellea) is a pear-shaped sac inserted between the under surface of the right lobe of the liver and the peritoneal serous membrane. It consists of three parts or regions: the neck, body (representing the main part of the organ), and fundus (a blind end). The neck is in continuity with the cystic duct, which connects the gallbladder with the common bile duct (ductus choledochus). The lack of morphological information concerning the normal human gallbladder, especially at the level of electron microscopy, was mentioned by Wallraff [1] and remains virtually unchanged to the present day. The reason for this lies in the difficulty or even impossibility of 1) obtaining healthy organs and 2) processing them quickly enough in order to achieve a satisfactory morphology. Most of our present knowledge on the structure and function of the gallbladder stems from studies on animals.
Keywords
Mast Cell Lamina Propria Dense Body Gallbladder Wall Principal CellPreview
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References
- 1.Wallraff J: Gallengangsystem, Gallenblase und Galle. In: Handbuch der Mikroskopischen Anatomie, Vol V/4. W Bargmann, (ed), Berlin: Springer, 277–363, 1969.Google Scholar
- 2.Schmidt CR, Ivy AC: The general function of the gall bladder. J Cell Comp Physiol 10: 365–383, 1937.CrossRefGoogle Scholar
- 3.Edholm P: Gallbladder evacuation in the normal male induced by cholecystokinin. Acta Radiol 53: 257–265, 1960.PubMedCrossRefGoogle Scholar
- 4.Mackie CR, Baxter JN, Grime JS, Hulks G, Cuschieri A: Gall bladder emptying in normal subjects — a data base for clinical cholescintigraphy. Gut 28: 137–141, 1987.PubMedCrossRefGoogle Scholar
- 5.Diamond JM: Transport mechanisms in the gallbladder. In: Handbook of Physiology: Alimentary Canal. CF Code (ed), Washington DC: American Physiological Society, 2451–2482 1969.Google Scholar
- 6.Geenen JE, Hogan WJ, Dodds WJ, Stewart ET, Arndorfer RC: Intraluminal pressure recording from the human sphincter of Oddi. Gastroenterology 78: 317–324, 1980.PubMedGoogle Scholar
- 7.Torsoli A, Ramorino ML, Alessandrini A: Motility of the biliary tract. Rendic R Gastroenterol 2: 67–80, 1970.Google Scholar
- 8.Whitehouse RW, Martin DF: Contrast-enhanced computed tomography of the normal and abnormal gallbladder. Br J Radiol 59: 1083–1085, 1986.PubMedCrossRefGoogle Scholar
- 9.Engel JM, Deitch EA, Sikkema W: Gallbladder wall thickness: sonographic accuracy and relation to disease. Am J Roentgenol 134: 907–909, 1980.Google Scholar
- 10.Fawcett DW: A Textbook of Histology, 11th ed. Philadelphia: WB Saunders, 1986.Google Scholar
- 11.Luciano L, Reale E, Wolpers C: Die Feinstruktur der Gallenblase und der Gallengänge. V. Histochemische Lokalisierung von Mukosustanzen im menschlichen Gallenblasenepithel. Histochemistry 38: 57–70, 1974.CrossRefGoogle Scholar
- 12.Thiéry JP: Mise en évidence des polysaccharides sur coupes fines en microscopie électronique. J Microscopie 6: 987–1018, 1967.Google Scholar
- 13.Mowry RW: Improved procedure for the staining of acidic polysaccharides by Müller’s colloidal (hydrous) ferric oxide and its combination with the Feulgen and the periodic acid-Schiff reactions. Lab Invest 7: 566–576, 1958.PubMedGoogle Scholar
- 14.Yoshitomi S, Miyazaki K, Nakayama F: Demonstration and maintenance of mucus secretion in cultured human gallbladder epithelial cells. In Vitro Cell Develop Biol 23: 559–566, 1987.CrossRefGoogle Scholar
- 15.Luciano L, Wermbter G, Reale E: Die Feinstruktur der Gallenblase und der Gallengänge. III. Beobachtungen an gefriergeätzten Präparaten der Gallenblase der Maus unter besonderer Berücksichtigung der dichten Körper und des Verbindungskomplexes. Cytobiologie 7: 76–88, 1973.Google Scholar
- 16.Nagahiro K: Zytologische Untersuchungen über die Epithelzelle der Gallenblase des Menschen. Cytologia (Tokyo) 9: 132–163, 1938.Google Scholar
- 17.Luciano L: Die Feinstruktur der Gallenblase und der Gallengänge. I. Das Epithel der Gallenblase der Maus. Z Zellforsch 135: 87–102, 1972.PubMedCrossRefGoogle Scholar
- 18.Yamada E: The fine structure of the gall bladder epithelium of the mouse. J Biophys Biochem Cytol 1: 445–458, 1955.PubMedCrossRefGoogle Scholar
- 19.Hayat MA: Fixation for Electron Microscopy. New York: Academic Press, 1981.Google Scholar
- 20.Pfuhl W: Die Gallenblase und die extrahepatischen Gallengänge. In: Handbuch der Mikroskopishen Anatomie des Menschen, vol 5. von W Möllendorff (ed), Berlin: Springer Verlag, 426–462, 1932.Google Scholar
- 21.Evett RD, Higgins JA, Brown AL Jr: The fine structure of normal mucosa in human gall bladder. Gastroenterology 47: 49–60, 1964.PubMedGoogle Scholar
- 22.Bader G: Die submikroskopische Struktur des Gallenbla-senepithels. III. Mitteilung. Das Epithel der Steingallenblase des Menschen. Frank Z Path 74: 501–511, 1965.Google Scholar
- 23.Bartels H, Welsch U: Freeze fracture study of the turtle lung. 2. Rod-shaped particles in the plasma membrane of a mitochondria-rich pneumocyte in Pseudemys (Chrysemys) scripta. Cell Tissue Res 236:453–457, 1984.PubMedCrossRefGoogle Scholar
- 24.Wallraff J, Dietrich KF: Zur Morphologie and Histochemie der Steingallenblase des Menschen. Z Zellforsch 46: 155–231, 1957.PubMedCrossRefGoogle Scholar
- 25.Toledo OMS, Morales CR, Pereyra LA, Jordao T, Montes GS: Migrating mast cells in the gallbladder epithelium of cattle and sheep. Histochemistry 72: 433–442, 1981.PubMedCrossRefGoogle Scholar
- 26.Enerback L: Mast cell heterogeneity: the evolution of the concept of a specific mucosal mast cell. In: Mast Cell Differentiation and Heterogeneity. AD Befus, J Bienenstock, JA Denburg (eds). New York: Raven Press, 1–26, 1986.Google Scholar
- 27.Solcia E, Capelra C, Vassallo G, Buffa R: Endocrine cells of the gastric mucosa. Int Rev Cytol 42: 223–286, 1975.PubMedCrossRefGoogle Scholar
- 28.Luciano L, Reale E: A new morphological aspect of the brush cells of the mouse gallbladder epithelium. Cell Tissue Res 201: 37–44, 1979.PubMedCrossRefGoogle Scholar
- 29.Luciano L, Castellucci M, Reale E: The brush cells of the common bile duct of the rat. Thin section, freeze-fracture and scanning electron microscopy. Cell Tissue Res 218: 403–420, 1981.PubMedCrossRefGoogle Scholar
- 30.Erspamer V: Die enterochromaffinen Zellen der Gallenwege in normalen und pathologischen Zuständen. (Nach Untersuchungen beim Menschen und bei Säugetieren.) Virchows Arch 296: 70–92, 1936.Google Scholar
- 31.Erspamer V: Sulla presenza di cellule argentofile (preenterocromaffini) nelle vie biliari dell’uomo e di alcuni mammiferi. Anat Anz 85: 272–284, 1938.Google Scholar
- 32.Laitio M, Nevalainen T: Ultrastructure of endocrine cells in metaplastic epithelium of human gall bladder. J Anat 120: 219–225, 1975.PubMedGoogle Scholar
- 33.Claude P, Goodenough DA: Fracture faces of zonulae occludentes from “tight” and “leaky” epithelia. J Cell Biol 58: 390–400, 1973.PubMedCrossRefGoogle Scholar
- 34.Bullivant S: Possible relationships between tight junction structure and function. In: Epithelial Ion and Water Transport. ADC Micknight, JP Leader (eds), New York: Raven Press, 265–275, 1981.Google Scholar
- 35.Castellucci M, Familiari G, Caggiati A: Heterogeneous distribution of ruthenium red-proteoglycan aggregates in the basement membrane (BM) of the gallbladder epithelium. In: The Extracellular Matrix: Chemistry, Biology, Pathology. J Jeffry, B Mecham (eds), St Louis: Washington University Press, 1982.Google Scholar
- 36.Montes GS, Bezerra MSF, Junqueira LCU: Collagen distribution in tissues. In: Ultrastructure of the Connective Tissue Matrix. A Ruggeri, PM Motta (eds), Boston: Martinus Nijhoff Publishers, 65–88, 1984.Google Scholar
- 37.Ivy AC, Oldberg E: A hormone mechanism for gallbladder contraction and evacuation. Am J Physiol 86: 599–613, 1928.Google Scholar
- 38.Mutt V, Jorpes JE: Structure of porcine cholecystokinin-pancreozyimin. 1. Cleavage with thrombin and with trypsin. Eur J Biochem 6: 156–162, 1968.PubMedCrossRefGoogle Scholar
- 39.Morley JE: The ascent of cholecystokinin (CCK) — from Gut to brain. Life Sci 30: 479–493, 1982.PubMedCrossRefGoogle Scholar
- 40.Walsh JH: Gastrointestinal Hormones. In: Physiology of the Gastrointestinal Tract, 2nd ed. LR Johnson (ed), New York: Raven Press, 181–253, 1987.Google Scholar
- 41.Ryan JP: Motility of the gallbladder and biliary tree. In: Physiology of the Gastrointestinal Tract, 2nd ed. LR Johnson (ed), New York: Raven Press, 695–721, 1987.Google Scholar
- 42.Byrnes DJ, Borody T, Daskalopoulos G, Boyle M, Benn I: Cholecystokinin and gallbladder contraction: effect of CCK infusion. Peptides 2: 259–262, 1981.PubMedCrossRefGoogle Scholar
- 43.Wiener I, Inoue K, Fagan CJ, Lilja P, Watson LC, Thompson JC: Release of cholecystokinin in man. Correlation of blood levels with gallbladder contraction. Ann Surg 194: 321–325, 1981.PubMedCrossRefGoogle Scholar
- 44.Lilja P, Fagan CJ, Wiener I, Inoue K, Watson LC, Rayford PL: Infusion of pure cholecystokinin in humans. Correlation between plasma concentrations of cholecystokinin and gallbladder size. Gastroenterology 83: 256–261, 1982.PubMedGoogle Scholar
- 45.Sacchetti G, Mandelli V, Roncoroni L, Montanari C: Influence of age and sex on gallbladder emptying induced by a fatty meal in normal subjects. Am J Roentgenol 119: 40–50, 1973.Google Scholar
- 46.Kaene P, Colwell D, Baer HP, Clanachan AS, Scott GW: Effects of age, gender and female sex hormones upon contractility of the human gallbladder in vitro. Surg Gynecol Obstet 163: 555–560, 1986.Google Scholar
- 47.Upp JR, Nealon WH, Singh P, Fagan CJ, Jonas AS, Greeley GH, Thompson JC: Correlation of cholecy-stokinin receptors with gallbladder contractility in patients with gallstones. Ann Surg 205: 641–648, 1987.PubMedCrossRefGoogle Scholar
- 48.LaMorte WW, Schoetz DJ, Birkett DH, Williams LF: The role of the gallbladder in the pathogenesis of cholesterol gallstones. Gastroenterology 77: 580–592, 1979.PubMedGoogle Scholar
- 49.Chevreul M: Recherches chimiques sur les corps gras, et particulièrement sur leurs combinaisons avec les alcalis. Sixième Mémoire. Examen des graisses d’homme, de mouton, de boeuf, de jaguar et d’oie. Ann Chim Phys 2: 339–372, 1816.Google Scholar
- 50.Berthelot M: Sur plusieurs alcools nouveaux. Combinaisons des acides avec la Cholestérine, l’éthal, le camphre de Bornéo et la méconine. Ann Chim Phys 56: 51–98, 1859.Google Scholar
- 51.Mead JF, Alfin-Slater RB, Howton DR, Popjak G: Biosynthesis of cholesterol and related substances. In: Lipids. Chemistry, Biochemistry, and Nutrition. New York: Plenum Press, 295–367, 1986.Google Scholar
- 52.Cooperberg PL, Gibney RG: Imaging of the gallbladder, 1987. Radiology 163: 605–613, 1987.PubMedGoogle Scholar
- 53.Glenn F: Biliary tract disease since antiquity. Bull NY Acad Med 47: 329–350, 1971.Google Scholar
- 54.Gracie WA, Ransohoff DF: The natural history of silent gallstones. The innocent gallstone is not a myth. N Engl J Med 307: 798–800, 1982.PubMedCrossRefGoogle Scholar
- 55.Wolpers C, Blaschke R: Electron microscopy of human gallstones. In: 29th Ann Proc Electron Microscopy Soc Amer. CJ Arceneaux (ed), Baton Rouge, LA: Claitor’s Publishing Division, 296–297, 1971.Google Scholar
- 56.Wolpers C: Gallenblasensteine. Ihre Morphogenese und Auswahl zur Litholyse. Basel: Karger Verlag, 1987.Google Scholar
- 57.Myant NB: Cholesterol gallstones; plasma cholesterol in liver disease. In: The Biology of Cholesterol and Related Steroids. London: Heinemann Medical Books, 853–387, 1981.Google Scholar
- 58.L Capocaccia, G Ricci, F Angelico, M Angelico, AF Attili (eds): Epidemiology and Prevention of Gallstone Disease. Lancaster: MTP Press, 1984.Google Scholar
- 59.Holzbach RT: Recent progress in understanding cholesterol crystal nucleation as a precursor to human gallstone formation. Hepatology 6: 1403–1406, 1986.PubMedCrossRefGoogle Scholar
- 60.Smith BF: Human gallbladder mucin binds biliary lipids and promotes cholesterol crystal nucleation in model bile. J Lipid Res 28: 1088–1097, 1987.PubMedGoogle Scholar
- 61.Nevalainen T, Laitio M: Ultrastructure of gallbladder with cholesterolosis. Virchows Arch Abt B Zellpath 10: 237–242, 1972.Google Scholar
- 62.Luciano L, Wolpers C: Die Feinstruktur der Gallenblase und der Gallengänge. IV. Die Cholesterose der menschlichen Gallenblasenschleimhaut. Virchows Arch Abt B Zellpath 14: 147–158, 1973.Google Scholar
- 63.Koga A: Fine structure of the human gallbladder with cholesterosis with special reference to the mechanism of lipid accumulation. Br J Exp Path 66: 605–611, 1985.Google Scholar
- 64.Williamson JR: Ultrastructural localization and distribution of free cholesterol (3β hydroxysterols) in tissues. J Ultrastruct Res 27: 118–133, 1969.CrossRefGoogle Scholar
- 65.Koga A, Todo S, Nishimura M: Electron microscopic observations on the cholesterol distributed in the epithelial cells of the gallbladder. Histochemistry 44: 303–306, 1975.PubMedCrossRefGoogle Scholar
- 66.Elias PM; Goerke J, Friend DS: Freeze-fracture identification of sterol-digitonin complexes in cell and liposome membranes..J Cell Biol 78: 577–596, 1978.PubMedCrossRefGoogle Scholar
- 67.Rose RC: Absorptive functions of the gallbladder. In: Physiology of the Gastrointestinal Tract, 2nd ed. LR Johnston (ed), New York: Raven Press, 1455–1468, 1987.Google Scholar
- 68.Kaye GI, Wheeler HO, Whitlock RT, Lane N: Fluid transport in the rabbit gallbladder. A combined physiological and electron microscopic study. J Cell Biol 30: 237–268, 1966.PubMedCrossRefGoogle Scholar
- 69.Castellucci M, Caggiati A: Surface aspects of the rabbit gallbladder mucosa and their functional implications. J Submicrosc Cytol 12: 375–390, 1980.Google Scholar
- 70.Nielsen OV, Nielsen ML, Lauritzen KEF: Examination of the mucosa of the normal human gall bladder by scanning electron microscopy. Micron 5: 281–291, 1975.Google Scholar