ABSTRACT
The gallbladder is pear-shaped and about 10 cm in length. It is attached to the inferior surface of the right lobe of the liver and is enclosed within a peritoneal sheath. The extent of this attachment varies from a gallbladder that is embedded deeply within the liver, to one that presents on a mesentery, rendering it liable to volvulus. Commonly, the lower end or fundus of the gallbladder is completely covered with peritoneum and projects slightly beyond the free margin of the liver. The body and neck are usually covered only on three sides by peritoneum, the gallbladder being attached anteriorly to the liver by loose connective tissue and easily separated from it. The neck narrows down to form the cystic duct. If a gallstone becomes lodged in the neck of the gallbladder, it creates a dilatation at this point, known as Hartmann’s pouch. The cystic duct, which is of variable length and width, runs backwards and medially and joins the common hepatic duct to form the bile duct. As the bile duct is still more often known to surgeons as the common bile duct, this name is used predominantly in the text. The mucosa of the cystic duct is arranged in spiral folds, the valve of Heister. The gallbladder is supplied by the cystic artery, which is usually a branch of the right hepatic artery, though this is very variable.
