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1. Digestive System:
Gall Bladder & Pancreas
H. NHAYR, SHAHEEN N.
Bio 158 - LM

2. GALLBLADDER
 The gallbladder is a small,
pear-shaped, hollow organ
attached to the inferior surface
of the liver.
 It is where bile is stored and
concentrated before it is
released into the small
intestine.
 It is divided into 3 sections:
 fundus
 body
 neck

3. GALLBLADDER
WALL OF GALLBLADDER 1. Mucosa
 Simple Columnar Epithelium
 Lamina propria
 loose connective tissue
 diffuse lymphatic tissue
 venule and arteriole
2. Muscularis
 smooth muscle fibers
 Connective tissue layer
 large blood vessels, artery
and veins
 lymphatics
 nerves
3. Adventitia or serosa
 covers the entire
unattached gallbladder
surface
MUCOSA
MUSCULARIS
SEROSA

4. MUCOSA

5. MUSCULARIS

6. GALLBLADDER
BILIARY TRACT
 The hepatic, cystic, and common bile
ducts are lined with a mucous membrane
having a simple columnar epithelium of
cholangiocytes.

7. Sphincter of Oddi
CHOLECYSTOKININ
(CCK)
LIVER
ILEUM
(of Vater)
fasciculus longitudinalis

8. • The primary functions of the gallbladder are to collect, store,
concentrate, and expel bile when it is needed for emulsification of fat.
• Bile is continually produced by liver hepatocytes and transported via
the excretory ducts to the gallbladder for storage. Here, sodium is
actively transported through the simple columnar epithelium of the
gallbladder into the extracellular connective tissue, creating a strong
osmotic pressure. Water and chloride ions passively follow, producing
concentrated bile.
GALLBLADDER
FUNCTIONAL CORRELATIONS

9. PANCREAS
 is a pinkish-white organ lying retroperitoneally
on the posterior wall of the abdmonial cavity,
at the level of the second and third lumbar
vertebrae
 It is located in the upper left part of
abdominal cavity behind the stomach.
 exocrine gland
 pancreatic juice
 digestive enzymes
 proteases
 lipase
 amylase
 endocrine gland
 insulin
 glucagon
 somatostatin
 pancreatic polypeptide

10. PANCREAS
ENDOCRINE PANCREAS
EXOCRINE PANCREAS
1. EXOCRINE PORTION
- secretes daily about 1200 ml
of an enzyme-rich fluid
required for the digestion of
dietary fats, carbohydrates,
and proteins.
2. ENDOCRINE PORTION-
- secretes hormones essential
for the control of carbohydrate
metabolism.
It consists of:

12. PANCREAS
EXOCRINE PANCREAS
 Most of the pancreas is an exocrine gland.
 acini- exocrine secretory units
 consists of a single layer of 40-50
pyramidal epithelial cells sorrounding a
lumen.
 base of the acinar cells are strongly
basophilic
 apex is abundant with secretory
granules containing zymogen precursors
of the pancreatic enzymes
 centroacinar cells - duct cells, secrete
aqueous bicarbonate solution
Acinar Tissue

13. Secretin and cholecystokinin (CCK)
－ secreted by the enteroendocrine cells into the bloodstream, regulate
pancreatic secretions.
• Secretin - stimulates exocrine pancreatic cells to produce large amounts of a
watery fluid rich in sodium bicarbonate ions.
 This fluid, which has little or no enzymatic activity, is primarily produced by
centroacinar cells in the acini and by cells that line the smaller intercalated
ducts.
 The main function of this bicarbonate fluid is to neutralize the acidic chyme,
stop the action of pepsin from the stomach, and create a neutral pH in the
duodenum for the action of the digestive pancreatic enzymes.
EXOCRINE PANCREAS

14. • CCK - stimulates the acinar cells in the pancreas to secrete large amounts
of digestive enzymes: pancreatic amylase for carbohydrate digestion,
pancreatic lipase for lipid digestion, deoxyribonuclease and ribonuclease
for digestion of nucleic acids, and the proteolytic enzymes trypsinogen,
chymotrypsinogen, and procarboxypeptidase.
 Pancreatic enzymes are first produced in the acinar cells in an inactive
form and are only activated in the duodenum by the hormone
enterokinase secreted by the intestinal mucosa.
 This hormone converts trypsinogen to trypsin, which then converts all
other pancreatic enzymes into active digestive enzymes.
EXOCRINE PANCREAS

15. EXOCRINE PANCREAS
PANCREATIC DUCTS
1. Main Pancreatic Duct (Duct of Wirsung)
• duct joining the pancreas to the
common bile duct to supply
pancreatic juice provided from the
exocrine pancreas.
• It joins the common bile duct to
form hepatopancreatic ampulla (of
Vater)
2. Accessory Pancreatic Duct (Duct of
Santorini)
• drains a small upper portion of the
pancreatic head and terminates it in
the duodenum as a small accessory
papilla.
• derived from pancreatic bud.

16. EXOCRINE PANCREAS
Duct Tissue

17. PANCREAS
ENDOCRINE PANCREAS
• Each islet is surrounded by fine fibers
of reticular connective tissue.
• With special immunocytochemical
processes, four cell types can be
identified in each pancreatic islet:
 alpha cells
 beta cells
 delta cells
 pancreatic polypeptide (PP)
cells.
Islets of Langerhans (Pancreatic Islets)

19.  Alpha cells: secretes glucagon
 elevates blood glucose levels by accelerating the
conversion of glycogen, amino acids, and fatty
acids.
 Beta cells: secretes insulin
 lowers blood glucose levels by accelerating
membrane transport of glucose into liver, muscles,
and adipose cells.
 Delta cells: secretes somatostatin
 decreases and inhibits secretory activities of both
alpha and beta cells
 Pancreatic polypeptide cells: secretes pancreatic
polypeptide
 inhibits production of pancreatic enzymes and
alkaline solutions
PANCREAS
ENDOCRINE PANCREAS
Islets of Langerhans

20. RECENT STUDY OF GALLBLADDER
New Approach to Gallbladder Surgery: Smallest Reported Incision
A surgical team at UC San Diego Health has completed the first series of operations with a novel surgical system
that can remove a diseased gallbladder through a single incision hidden in the belly button.
Santiago Horgan, MD, chief of minimally invasive surgery, was able to successfully remove the gallbladder
through a 15-millimeter incision – roughly half an inch. This is believed to be the smallest reported successful
incision for this procedure.
Normally, a gallbladder removal would be performed with four incisions across the abdomen. The surgery was
achieved with one small cut hidden in the umbilicus. So not only are there fewer incisions, the one that remains is
incredibly small.
Horgan said the new approach is dramatically better for patients in terms of healing and appearance. He cited
fewer incision site complications, less post-operative pain, reduced chance of hernia, faster recovery and
exceptional cosmetic outcomes as potential benefits. The 30-minute procedure was performed under general
anesthesia. Patients returned home the same day with no complications. Approximately 600,000 people per year
have their gallbladder surgically removed in the United States.
Horgan performed the gallbladder removal, also known as laparoscopic cholecystectomy, with the Fortimedix
FMX314 surgical system. The system was approved by the FDA in August 2016.
Reference: University of California San Diego Health Sciences. “New approach to a gallbladder surgery, smallest reported incision.”
ScienceDaily. ScienceDaily, 11 October 2016 <www.sciencedaily.com/releases/2016/10/161011131248.htm>

21. RECENT STUDY OF PANCREAS
A Fasting Diet Could Reverse Diabetes And Repair The Pancreas, Says New Research
The research explains that the diet triggers the pancreas to regenerate itself, which works to control blood
sugar levels and reverse symptoms of diabetes.
The scientists put mice into an artificial fasting mode for four days a week over a period of several months to
regenerate beta cells in the pancreas, which stores and releases insulin, and saw that working cells took the
place of damaged ones. The team even experimented on pancreatic cell cultures from human donors affected
by type I diabetes, and found that the diet generated additional insulin, as well as the Ngn3 protein needed to
ensure the pancreas functions correctly.
Having been tested only on mice and on human cells in lab conditions, there is still a ways to go to prove its
efficacy in the real world. Researchers also advise against trying it at home as a means for treating diabetes.
According to the team from the University of Southern California, the diet reverses, for mice, symptoms of
type I diabetes, which occurs when the pancreas can’t make insulin, and type II diabetes, which occurs when
the pancreas is damaged by insulin resistance.
Reference:
Cheng, Chia-Wei , Villani, Valentina, et al. (2017). “Fasting-Mimicking Diet Promotes Ngn3-Driven β-Cell Regeneration to Reverse Diabetes.”
Cell. Available from: http://dx.doi.org/10.1016/j.cell.2017.01.040

22. THANK YOU~