On the mechanical behavior of the human biliary system

• Published in: World journal of gastroenterology : WJG Vol. 13; no. 9; pp. 1384 - 1392
• Main Authors: Luo, Xiaoyu, Li, Wenguang, Bird, Nigel, Chin, Swee Boon, Hill, N A, Johnson, Alan G
• Format: Journal Article
• Language: English
• Published: United States Department of Mathematics, University of Glasgow, Glasgow, G12 8QW, United Kingdom%Department of Mechanical Engineering, University of Sheffield, Sheffield, S1 3JD,United Kingdom%Academic Surgical Unit, Royal Hallamshire Hospital, Sheffield, S10 2JF, United Kingdom 07.03.2007; Baishideng Publishing Group Co., Limited
• Subjects: Biliary Tract - physiology; Biomechanical Phenomena; Gallbladder Diseases - physiopathology; Gallbladder Emptying - physiology; Gallstones - physiopathology; Humans; Models, Biological; Models, Theoretical; Pain - physiopathology; Rheology; Topic Highlights; 流体动力学; 胆汁系统; 胆结石; Acalculous biliary pain; Bile flow; Fluid dynamics; Soft tissue mechanics; Cystic duct; Gallbladder; Mechanical factors; Stress; Gallstone
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v13.i9.1384

This paper reviews the progress made in understanding the mechanical behaviour of the biliary system. Gallstones and diseases of the biliary tract affect more than 10% of the adult population. The complications of gallstones, i.e. acute pancreatitis and obstructive jandice, can be lethal, and patients with acalculous gallbladder pain often pose diagnostic difficulties and undergo repeated ultrasound scans and oral cholecystograms. Moreover, surgery to remove the gallbladder in these patients, in an attempt to relieve the symptoms, gives variable results. Extensive research has been carried out to understand the physiological and pathological functions of the biliary system, but the mechanism of the pathogenesis of gallstones and pain production still remain poorly understood. It is believed that the mechanical factors play an essential role in the mechanisms of the gallstone formation and biliary diseases. However, despite the extensive literature in clinical studies, only limited work has been carried out to study the biliary system from the mechanical point of view. In this paper, we discuss the state of art knowledge of the fluid dynamics of bile flow in the biliary tract, the solid mechanics of the gallbladder and bile ducts, recent mathematical and numerical modelling of the system, and finally the future challenges in the area.