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University of Cebu College of Nursing

A Resource Unit on

CHOLEDOCHOLITHIASIS

Submitted To:

MS. LOUIE GRACE A. MIRAFLOR, R.N Clinical Instructor Submitted By: Group 1 – 3Z Adolfo, Dally Love Antor, Ma. Laarni Barbante, Ginnel Baronda, Duiza Jane Batucan, Marlon Jayke Bayron, Clifford Borden, Jo Ann Candia, Jay An Canete, Dale Catubag, Charlyn Cuizon, Karen Mae Darunday, Avril Daffodil September 19,2009

General Objectives: After 2 hours of varied lecture discussion we the group1 BSN3-Z students will be able to acquire basic knowledge, beginning skills and positive attitudes towards the concept of CHOLEDOCHOLITHIASIS.

The biliary system consists of the organs and ducts (bile ducts, gallbladder, and associated structures) that are involved in the production and transportation of bile. The transportation of bile follows this sequence: 1. When the liver cells secrete bile, it is collected by a system of ducts that flow from the liver through the right and left hepatic ducts. 2. These ducts ultimately drain into the common hepatic duct. 3. The common hepatic duct then joins with the cystic duct from the gallbladder to form the common bile duct, which runs from the liver to the duodenum (the first section of the small intestine). 4. However, not all bile runs directly into the duodenum. About 50 percent of the bile produced by the liver is first stored in the gallbladder, a pear-shaped organ located directly below the liver. 5. Then, when food is eaten, the gallbladder contracts and releases stored bile into the duodenum to help break down the fats. Functions of the biliary system: The biliary system's main function includes the following: • •

to drain waste products from the liver into the duodenum to help in digestion with the controlled release of bile

Bile is the greenish-yellow fluid (consisting of waste products, cholesterol, and bile salts) that is secreted by the liver cells to perform two primary functions, including the following: • •

to carry away waste to break down fats during digestion

Bile salt is the actual component which helps break down and absorb fats. Bile, which is excreted from the body in the form of feces, is what gives feces its dark brown color. The gallbladder is about 7-10 cm long in humans and appears dark green because of its contents (bile), rather than its tissue. It is connected to the liver and the duodenum by the biliary tract. •

The liver is located in the upper right-hand portion of the abdominal cavity, beneath the diaphragm, and on top of the stomach, right kidney, and intestines. Shaped like a cone, the liver is a dark reddish-brown organ that weighs about 3 pounds.

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The cystic duct connects the gallbladder to the common hepatic duct to form the common bile duct.

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The Common bile duct then joins the pancreatic duct, and enters through the hepatopancreatic ampulla at the major duodenal papilla.

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Gallstones (cholesterol stones or pigment stones) form in the gallbladder over many years. They can sometimes travel into the common bile duct, causing a blockage. If the common bile duct is blocked, this then obstructs the whole of the biliary drainage system as opposed to a blockage further up. Hence there is nowhere for the bile to go but up and the patient becomes jaundiced since certain waste products (bilirubin) are absorbed back into the blood stream. Furthermore there can be potentially fatal complications of infection of the biliary tree (cholangitis) and acute pancreatitis.

The liver produces bile which aids in the digestion of fats. The bile travels through tiny canals which eventually drain through the common bile duct into the small intestine. The gallbladder stores excess bile that is not immediately needed for digestion.