Liver, Gallbladder, Pancreas & Biliary Tract

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Digestive conditions, testing, and treatments.

All Digestive Diseases and Conditions We Treat

At MUSC Health, we treat a full range of digestive diseases, from common GI issues to complex conditions.

Diagnostic Tests for Digestive Health

We offer advanced diagnostic tests to evaluate digestive issues and determine the best care options.

Digestive Health, Surgical Treatments, and Programs

MUSC Health offers expert surgical treatments and programs for complex and routine digestive conditions

What is the liver?

Located in the upper, right-hand portion of the abdomen up under the rib cage, the liver is the second-largest organ in the body. A very complex and dynamic organ, the liver manages clotting factors in the blood, cleanses the blood of toxins, controls numerous enzymes and proteins, controls cholesterol levels, and produces bile to aid in the digestion of food.

Bile helps dissolve lipids. Bile is a yellow, bitter liquid —mostly water, but also containing bile salts— that dissolves fats so that the its energy can be absorbed by the body. Bile also reduces the acidity of the contents of the stomach once it enters into the duodenum.

Understanding the liver

Unlike most organs, the liver can regenerate lost tissue, and this fact has had an enormous impact on the field of liver transplantation.

The liver was once thought of as one of the most important organs in the body, along with the heart and brain. It was thought to control a person's emotions, and to be called 'pigeon-livered' was to imply you were a meek and spineless person. A large liver endowed a person with courage and daring.

Liver damage can be caused by many factors. Alcohol and some drugs are toxic to the liver, but damage can also occur because of infections, and even exposure to some types of shellfish. When the liver is damaged, the body is unable to perform these vital functions. People with liver disorders experience fatigue and nausea.

Perhaps the most often-heard statement in drug advertisements is, "Do not take this if you have liver problems." All drugs are filtered through the liver, and this can have adverse effects on the treatment of patients with liver damage.

Liver and Pancreas Surgery

What is the gallbladder?

The gallbladder is a small organ that stores bile. It is attached to your digestive system by a system of hollow ducts called the biliary tree. The gallbladder sits in an indenture underneath the right lobe of the liver. It is about one inch wide and three inches long, and tapered at one end where it connects to the cystic duct. It is a muscular organ that contracts when bile is needed, and forces the enzyme through the cystic duct.

There are three main parts of the gallbladder:

fundus — the large end that stores bile juices
body — not as large and begins to taper
neck — tapers further and connects to the cystic duct

The connection to the cystic duct is known as Hartmann’s Pouch. When gallstones get stuck, it is usually at this juncture.

The gallbladder creates a reservoir for bile, also known as gall, hence the name gallbladder. The bile that is stored here is actually manufactured in the liver. The bladder itself is not very large; however, bile is a strong enzyme.

Understanding the gallbladder.

Fat is difficult to digest. It resists being broken down into usable energy. Bile is a strong enzyme that assists in breaking fats down. When the food you eat contains fat, the stomach and duodenum secrete a substance that stimulates the gallbladder to contract, thereby forcing bile into the digestive tract. Bile emulsifies the fat, making it available for energy production.

The gallbladder stores bile juices and strong enzymes that in some instances can create stones called gallstones. These stones irritate the lining of the gallbladder, and sometimes migrate through the biliary tree. Most of the time this occurs without incident; however, stones can become lodged in the biliary tract. This causes severe pain.

Gallbladder removal is a common medical procedure that has little effect on the lifestyle. You may experience some discomfort if you eat a diet high in fat. Remember that the gallbladder stores and secretes enzymes for the purpose of breaking down fat so that it may be used as energy for the body. Your doctor will have more information about any lifestyle changes you may wish to consider.

What is the pancreas?

The pancreas, an organ situated near the stomach that is approximately the same size and shape as a small banana, uses the pancreatic duct to supply pancreatic juices that also assist with digestion. These juices, or secretions, are referred to as exocrine juices. The biliary tree can also be obstructed by gallstones to the extent that the pancreas is unable to supply exocrine juices to the duodenum. This can result in a very dangerous condition called pancreatitis.

What is the biliary tree?

The stomach is where food is initially broken down for the purpose of digestion, after which it travels into the first part of the small intestine, commonly referred to as the duodenum. In the duodenum, digestive juices (secretions) are added that further process the food into usable energy for the body. These secretions come via the biliary tree.

The biliary tree is a system of vessels that directs these secretions from the liver, gallbladder and pancreas through a series of ducts into the duodenum. The exit hole into the duodenum is called the papilla of Vater. (Because of the structure of the connections to each organ, the biliary tree, or tract, bears some resemblance to a tree and its branches, hence the name.)

An X-ray image of the biliary tree during an ERCP.

Breaking down fats —also known as lipids, fats are very concentrated forms of energy essential for proper growth and maintenance of the body— is an important part of the digestive process. However, lipids that are still present in foods that have been passed from the stomach to the duodenum are quite difficult to dissolve.