Motility of the biliary system

Dodds, Wylie J.; Hogan, Walter J.; Geenen, Joseph E.

doi:10.1002/cphy.cp060128

Cited by 19 publications

(20 citation statements)

References 153 publications

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“…p e = 11 mmHg. 10 Such an assumption is in line with the experimental observation of human gallbladder pressure made by Body et al 5 In other words, refilling is an isotonic process.…”

Section: Cck Provocation Testsupporting

confidence: 64%

A Mechanical Model for CCK-Induced Acalculous Gallbladder Pain

Luo

Hill

et al. 2010

Ann Biomed Eng

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Abstract-This study investigates the potential correlation between acalculous biliary pain and mechanical stress during the bile-emptying phase. This study is built on the previously developed mathematical model used to estimate stress in the gallbladder wall during emptying [Li, W. G., X. Y. Luo, et al. Comput. Math. Methods Med. 9(1):27-45, 2008]. Although the total stress was correctly predicted using the previous model, the contribution from patient-specific active stress induced by the cholecystokinin (CCK) test was overlooked. In this article, we evaluate both the active and passive components of pressure in a gallbladder, which undergoes isotonic refilling, isometric contraction and emptying during the infusion of CCK. The pressure is estimated from in vivo ultrasonographical scan measurements of gallbladder emptying during CCK tests, assuming that the gallbladder is a thin ellipsoidal membrane. The passive stress is caused by the volume and shape changes during refilling at the gallbladder basal pressure, whereas the active stress arises from the pressure rise during the isometric gallbladder contraction after the CCK infusion. The effect on the stress estimates of the gallbladder to the liver is evaluated to be small by comparing numerical simulations of a gallbladder model with and without a rigid 'flat top' boundary. The model was applied to 51 subjects, and the peak total stress was found to have a strong correlation with the pain stimulated by CCK, as measured by the patient pain score questionnaires. Consistent with our previous study for a smaller sample, it is found that the success rate in predicting of CCK-induced pain is over 75%.

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“…p e = 11 mmHg. 10 Such an assumption is in line with the experimental observation of human gallbladder pressure made by Body et al 5 In other words, refilling is an isotonic process.…”

Section: Cck Provocation Testsupporting

confidence: 64%

A Mechanical Model for CCK-Induced Acalculous Gallbladder Pain

Luo

Hill

et al. 2010

Ann Biomed Eng

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show abstract

“…This suggests that the folds projecting into the lumen of the cystic duct may function as a flow resistor (passively) or regulator (if any contractile activity takes place in the muscle layer of the duct). Dodds et al (1989) suggested that it minimises the luminal pressure in the common bile duct thus avoiding excessive distension during the expulsion of gallbladder bile. The simulations here indicate that patients with a high resistance cystic duct (e.g.…”

Section: Article In Pressmentioning

confidence: 98%

“…Therefore, laminar flow may be assumed. In addition, as the average time to empty a gallbladder with a mean volume of 35 ml of bile is about 30 min (Dodds et al, 1989), the flow is sufficiently slow to be considered as steady state. Ultrasonographic and cholangiographic images show that the cystic duct may move with respiration.…”

Section: Assumptionsmentioning

confidence: 99%

The flow of bile in the human cystic duct

Ooi

Luo

Chin

et al. 2004

Journal of Biomechanics

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“…The Reynolds number, Re, based on mean velocity and mean duct diameter, thus varies from 1 to 40. In addition, as the average time to empty a gallbladder with a mean volume of 35 ml of bile is about 30 min [25], this study assumes that the flow is laminar and that it is sufficiently slow changing to consider that steady state conditions prevail.…”

Section: Flow Assumptionsmentioning

confidence: 99%

“…The maximum liver secretion pressure is approximately 30 cmH 2 O (2942 Pa) [26], while the human gallbladder has a resting pressure of around 10-20 cmH 2 O (980-1960 Pa) and requires a pressure head of only a few centimetres of water to empty the bile to the common bile duct [25]. Continuous in vivo manometry of human gallbladder showed that, after a meal, the pressure in the gallbladder increases to around 26.2-38.7 cmH 2 O (2569-3795 Pa).…”

Section: Fluid Pressure In the Biliary Systemmentioning

confidence: 99%