The concentrating activity of the gall bladder

Abstract

In a previous paper we have noted the fact that the fluid which collects in bile ducts experimentally obstructed is an inspissated, tarry bile when the ducts communicate with the gallbladder, whereas in ducts unconnected with this viscus the fluid is thin and soon becomes free from pigment and cholates. It has long been recognized that the gall-bladder must have a concentrating function, since bladder bile is more concentrated than duct bile from the same animal; and continued functioning during stasis will explain the tarry bile then found. The inspissation occurs so rapidly as to raise the question whether concentration of the bile in periods of intermittent or partial stasis may not be an important favoring element in the formation of gall-stones.

To determine the rate of concentration advantage has been taken of the arrangement of the hepatic ducts in the dog. There are three of these, which unite to form a common duct, with the cystic duct emptying high up into the central one. Through an opening near the lower end of this last a catheter was pushed into the neck of the gall-bladder, which was emptied and washed with salt solution; and the duct was ligated after the catheter had been withdrawn. The bile from the middle lobes of the liver had now no way of escape save into the gall-bladder. That from the lobes to either side still reached the common duct, but from this it was collected into a rubber balloon placed in the peritoneal cavity. The laparatomy incision was completely closed. The dogs tolerated the operation well. Control experiments in which a second balloon was substituted for the gall-bladder showed that the separated portions of bile differed little in their pigment content, which was taken as the index to concentration.