Hepatobiliary System (Nursing)

00:00 Welcome to our video series on the liver. In this one, we're going to break down the hepatobiliary system. So, let's start with an obvious question. What is included in the hepatobiliary system? Okay, all you have to do is break that word down. Hepato refers to the liver. Biliary references the gallbladder, the bile ducts, or bile. So, we're talking about the liver and bile, the things that store it, and the things that move it around. So, where is bile made? What's your guess? Right, bile is made in the hepatocytes. Now, what you see on your screen there is 1 lobule. That is one of 100,000 lobules you have in your liver. Now, the lobule is made of the 6 portal triads. Right, those 3 tubes, a bile duct, a part of the artery, and a part of the vein, that's a portal triad, and you have 6 sets of those all the way around the outside of the lobule, and bile is made by the hepatocytes. Those are the cells in between those portal triads in the center. Their job is to actually make the bile. Now, it gets sent through the bile canaliculi, little tiny tunnels, from the center to the outside of the lobule to the bile duct. Now that we know the hepatobiliary system references the liver and bile, let's break it down for you. So, we're going to put up on the screen a picture of the liver. Now, take a look at that. You'll notice that the right lobe of the liver is a little bigger than the left lobe of the live. Now, the dividing line between right and left is the falciform ligament. So, there you have your liver. Let's look at the biliary structures. We've got the hepatic part down, so let's look at the biliary structures. Now, remember we talked about the lobules, right.

01:49 Those are the functional working units of the liver, and they have hepatocytes, tiny little cells, cords of them within the lobule. They are the guys who make the bile. So, when they make the bile, remember it's sent through the lobules from the center to the outside into the bile ducts.

02:09 Now, those tiny little bile ducts in each lobule will eventually lead to the hepatic ducts, and you've got right hepatic ducts and left hepatic ducts for both lobes. Alright, so we've got the tiny little lobules, the hepatocytes are making the bile, then they send it to the outside of each lobule, connects with the hepatic duct, then those drain into the right and left hepatic ducts.

02:34 The right and left hepatic ducts come together in the, there you go, common hepatic duct.

02:41 Yey, okay. This makes perfect sense. The right hepatic ducts are on the right side, the left hepatic ducts are on the left side, and you've got the common hepatic duct where they both come together. Now, the next stop is going to be the gallbladder. Remember that the gallbladder is the storage bin, right. That's just an empty, open organ. There's nothing else in it because it's just meant to store. So, look at the little green line in between the common hepatic duct and the gallbladder. That's called the cystic duct because the gallbladder, it's named after the gallbladder. That's the duct that's going to drain bile into and out of the gallbladder. Alright, so so far, we've got the right and left hepatic ducts, they lead to the common hepatic duct, then you have the cystic duct in between the gallbladder and the common hepatic duct. Those all come together to form the common bile duct. Okay, cool, so that's pretty easy to remember. Right and left hepatic make the common hepatic duct, then you have the cystic duct piece added in there. That becomes the common bile duct because it's shared by all the organs involved. Now, if you keep following down the common bile duct, we'll come to the kind of funky-looking organ. Isn't it? That's your pancreas. It's not really attractive, but it does some amazing things. It's both an endocrine organ and an exocrine organ. Now, endocrine are the hormones it puts out into your bloodstream, but we're looking at its exocrine function because it puts some pancreatic juices into the bile for us. So, you follow that down. You see how the common bile duct ends up in the pancreatic duct. Now, right there, that big pink thing you just saw come on the screen, that's your small intestine. Now, where this all comes together and all this bile that's made in the liver, stored in the gallbladder, travels on down that common bile duct, joins into the pancreas at the pancreatic duct, you have a couple structures, the sphincter of Oddi and the ampulla of Vater. Okay, that's the entryway to the small intestine. We want to get bile from the liver into the small intestine because that will help your small intestine break down and process the food that you've eaten.