biliaires

Biliaires, or the biliary system, refers to the network of ducts, gallbladder, and associated structures that produce, transport, store, and release bile from the liver into the intestine. The intrahepatic bile ducts collect bile produced by hepatocytes and funnel it into the right and left hepatic ducts, which join to form the common hepatic duct. The gallbladder stores and concentrates bile, releasing it through the cystic duct into the common bile duct as needed. The common bile duct merges with the main pancreatic duct and opens into the duodenum at the ampulla of Vater, regulated by the sphincter of Oddi.

Physiology and function are centered on bile’s role in fat digestion and elimination of waste products. Bile contains bile acids, cholesterol, phospholipids, and bilirubin. Bile acids emulsify fats, aiding digestion, while bilirubin is a breakdown product of hemoglobin excreted in bile. Bile flow is regulated by neural and hormonal signals, with cholecystokinin prompting gallbladder contraction and relaxation of the sphincter of Oddi to allow bile into the intestine.

Clinical relevance encompasses a range of biliary disorders. Gallstones (cholelithiasis) can obstruct ducts, causing pain or pancreatitis. Cholangitis involves infection of the bile ducts, and cholestasis refers to impaired bile flow. Congenital biliary atresia and acquired cholangiopathies like primary sclerosing cholangitis affect ductal integrity. Biliary malignancies include cholangiocarcinoma.

Diagnostics and treatment commonly rely on imaging and endoscopy. Ultrasound is often first-line, with MRCP providing noninvasive duct visualization and ERCP offering both diagnostic and therapeutic options, such as stone removal or stent placement. Management ranges from medical observation to surgical cholecystectomy or biliary drainage, depending on the condition.