hepatobiliar

Hepatobiliar is an umbrella term for the liver and the biliary system, including the hepatic ducts, the gallbladder, and the bile ducts that drain bile into the digestive tract. The hepatobiliary system supports digestion, metabolism, detoxification, and immune functions.

Anatomy and physiology

The liver, the largest internal organ, receives blood from the hepatic artery and the portal vein. Hepatocytes produce bile, which is collected in canaliculi and drains into the right and left hepatic ducts. These join to form the common hepatic duct, which merges with the cystic duct from the gallbladder to create the common bile duct. Bile is released into the duodenum via the sphincter of Oddi. The gallbladder stores and concentrates bile between meals.

Functions include bile production for fat emulsification, carbohydrate and protein metabolism, detoxification of drugs and toxins, storage of vitamins and glycogen, and immune surveillance.

Common diseases

Hepatic diseases include viral hepatitis (types A–E and non-viral liver injury), alcoholic liver disease, and non-alcoholic fatty liver disease, which can progress to cirrhosis and liver failure. Hepatocellular carcinoma is a primary liver cancer. Biliary tract diseases include cholelithiasis (gallstones), cholecystitis (gallbladder inflammation), cholangitis (bile duct infection), choledocholithiasis (bile duct stones), primary sclerosing cholangitis, and primary biliary cholangitis. Biliary atresia occurs in infancy and affects bile flow.

Diagnosis and treatment

Evaluation relies on history, physical examination, and laboratory tests such as liver function tests (ALT, AST, ALP, GGT, bilirubin) and albumin. Imaging (ultrasound, CT, MRI, MRCP) and endoscopic procedures (ERCP) aid diagnosis. Treatments vary by condition and may include antiviral therapy for hepatitis, lifestyle modification for fatty liver disease, cholecystectomy for gallbladder disease, endoscopic or surgical biliary drainage, and liver transplantation for advanced liver disease.