Anatomical Duct 3 Letters
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Anatomical Duct 3 Letters
The gallbladder, a muscular membrane sac that stores and concentrates bile, a fluid received from the liver, is important for digestion. Located below the liver, the gallbladder is pear-shaped and has a capacity of about 50 mL (1.7 fluid ounces). The inner surface of the gallbladder wall is lined with mucous-membrane tissue similar to that of the small intestine. Mucous membrane cells have hundreds of microscopic projections called microvilli that increase the surface area of fluid absorption. Mucous membrane cells absorb water and inorganic salts from the bile, making the stored bile 5 times—but sometimes up to 18 times—more concentrated than when it was produced in the liver.
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Contraction of the muscular wall of the gallbladder is stimulated by the vagus nerve of the parasympathetic system and the hormone cholecystokinin produced in the upper intestine. Contractions result in bile being discharged into the duodenum of the small intestine. The bile duct consists of three branches arranged in a Y shape. The lower part is the common bile duct; It ends in the duodenal wall of the small intestine. A constriction at the end of the common duct, called the sphincter of Oddi, controls the flow of bile into the duodenum. The upper right branch is the hepatic duct leading to the liver, where bile is produced. The upper left branch, the cystic duct, passes into the gallbladder, where bile is stored.
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Bile drains from two parts of the liver into the hepatic and common bile ducts. If there is food in the small intestine, bile continues directly into the duodenum. If the small intestine is empty, the sphincter of Oddi closes, allowing bile flowing through the common duct to accumulate and back up the tube until it reaches the open cystic duct. Bile drains into the cystic duct and gallbladder, where it is stored and concentrated until needed. As food enters the duodenum, the common ductal sphincter opens, the gallbladder contracts, and bile enters the duodenum to aid in the digestion of fat.
Gallbladder is usually prone to many disorders, especially the formation of solid deposits called gallstones. Despite its function, it can be surgically removed without serious consequence.” Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, that’s all there is to it.” Margaret Mead
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Cite this article as: Ntonas A, Katsourakis A, Galanis N, et al. (July 27, 2020) Comparative Anatomical Study of Human and Pig Liver and Its Significance in Xenotransplantation. 12(7): e9411. doi:10.7759/.9411
The liver is a multifunctional organ; Due to its functional and structural complexity, there are many factors that can lead to insufficient function, a condition called liver failure. Transplantation is the only proper treatment for patients with liver failure. However, this treatment has several limitations, and the scientific community has considered pig-based methods due to their unique structural and cellular compatibility with humans. In this review, we performed a comparative anatomical study of the liver parenchyma and vascular network between humans and pigs to extract useful information for xenotransplantation and autologous cell or organ production in pigs. We reviewed articles from 2007 to 2019 and used Scopus, PubMed, and Google Scholar databases. We concluded that although human and pig livers differ in shape, the number of segments and the biliary and vascular system are similar, which makes pig livers useful in experimental surgery for xenotransplantation.
The functions of the liver are complex and fundamental to life. Parenchymal cells of the organ synthesize most of the components and inhibitors of coagulation and fibrinolytic systems . This organ also plays an important role in metabolism . In addition, the liver is a leading immune organ with functions to detect, capture, and remove bacteria, viruses, and macromolecules that enter the body through the gut [ 3 ]. Due to its functional and structural complexity, there are many factors that lead to liver failure . Liver transplantation is the only appropriate treatment for patients with end-stage organ disease . However, due to their limitations, the scientific community has considered using methods such as xenotransplantation from genetically modified animals, immunocompromised [6, 7], differentiation of autologous stem cells into hepatocyte-like cells , and autologous organs. generation in xenogenic animals . Several investigations of medical treatment and surgical techniques have been applied to pigs; This is possible due to their structural and cellular compatibility with humans, making them excellent candidates for liver xenotransplantation . Inspired by a comparative study between rat and human liver, Krupunga et al. In 2019 , the purpose of this review is to compare the anatomic components of the liver between human and porcine cases to increase existing knowledge based on recent literature.
We performed a comparative anatomical study of the liver parenchyma and vascular network between humans and pigs, extracting useful information for xenotransplantation and autologous cell or organ generation in pigs. Eligible articles for this review were extracted from the databases of Scopus, PubMed, and Google Scholar. The search terms used were as follows: liver, porcine, porcine, xenotransplantation, human, transplantation, liver failure. No review protocol exists. References of all included articles were searched to identify whether any more relevant articles existed. For analysis, we included only original articles written in English within the last 12 years. Case reports, conference abstracts, letters to the editor, and studies reporting incomplete or irrelevant data were excluded from the study.
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The liver is the largest intraperitoneal gland in the body. In pigs, the liver is located behind the diaphragm on the right side of the abdominal cavity. The shape of the porcine liver is lobular, thickened in the center, and becomes thinner at the periphery of the organ. It consists of four lobes and eight segments. The sinister hepatic lobe is divided into lobes hepatis sinister lateralis, segments II and III, and lobes hepatis sinister medialis, segment IV; The dexter hepatic lobe is divided into lobus hepatis dexter lateralis, which consists of segments I, VII, and VI, and a small, very thin quadrate lobe. Attached to the dexter lateralis hepatis lobes is a sixth lobe called the caudate lobe (Figure 1) .
In the human body, the liver is located at the top of the abdominal cavity, below the diaphragm, and above the stomach. The human liver has a triangular prism, decreasing in size from right to left. According to embryology, the liver primordium occurs on day 22 after conception . Crossley and Le Daurin hypothesized three distinct inductive processes operating in the endoderm. First, we have the formation of hepatocardiac mesoderm, which divides into hepatic and cardiac mesenchyme when the hepatic bud appears. After the second and third induction, the cells of the endodermal cords differentiate into hepatocytes, and we have the formation of liver sinusoids. By day 51, the intrahepatic veins achieve normal division and distribution, while the arteries and bile ducts do not rapidly progress to their mature form . Anatomically, it is divided into left, right, caudate and quadrate lobes . The liver is divided into eight compartments by an autonomic vascular network (Figure 2).
The human liver is supplied with blood from two main vessels – the portal vein and the hepatic artery. While the hepatic veins and their biliary system deliver blood to the circulation, the hepatic artery consists of two branches, the left and right hepatic arteries, which are connected to each segment of the liver (Figure 2) .
In pigs, the left gastric, splenic, and hepatic arteries form the basin celiac artery, a branch of the abdominal aorta. The hepatic artery in pigs is divided into left and right branches. The left branch divides into the ramus sinister medialis and ramus sinister lateralis, the main arterial vasculature of the left lobe, and the ramus quadratus, which supplies the accessory lobe and gallbladder. The right branch divides into two branches, ramus dexter medialis and ramus dexter lateralis, which supply the right side.