Three-dimensional scaled-up transparent models of three human cystic ducts were prepared on the basis of anatomical specimens. The measurement of pressure drop across the cystic duct models and visualization of the flow structures within these ducts were performed at conditions replicating the physiological state. The flow visualization study confirmed the laminar nature of the flow of bile inside the cystic duct and values of pressure drop coefficient (Cp) decreased as the Reynolds number (Re) increased. The three tested models showed comparable behavior for the curve of Reynolds number versus the pressure drop coefficient. The results show that the tested cystic ducts have both increased pressure drop and complicated flow structures when compared with straight conduits. High resistance in a cystic duct may indicate that the gallbladder has to exert large force in expelling bile to the cystic duct. For patients with diseased gallbladder, and even in healthy persons, gallbladder is known to stiffen with age and it may lose its compliance or flexibility. A high resistance cystic duct coupled with a stiffened gallbladder may result in prolonged stasis of bile in the gallbladder, which is assumed to encourage the formation of gallstones.

1.
Shaffer
,
E. A.
, 2000, “
Control of Gallbladder Motor Function
,”
Aliment. Pharmacol. Ther.
,
14
, pp.
2
8
.
2.
Ooi
,
R. C.
,
Luo
,
X. Y.
,
Chin
,
S. B.
,
Johnson
,
A. G.
, and
Bird
,
N.
, 2004, “
Numerical Simulation of Bile Flow in Human Cystic Duct
,”
J. Biomech.
0021-9290,
37
, pp.
1913
1922
.
3.
Liddle
,
R. A.
,
Gerty
,
B. J.
,
Kanayam
,
S.
,
Beccaria
,
L.
,
Coker
,
L. D.
,
Turnbull
,
T. A.
, and
Morita
,
E. T.
, 1989, “
Effect of a Novelcholecystokinin (CCK) Receptor Antagonist, MK-329, on Gallbladder Contraction and Gastric Emptying in Humans
,”
J. Clin. Invest.
0021-9738,
84
, pp.
1220
1225
.
4.
Holzbach
,
R. T.
,
Marsh
,
M.
,
Olszewski
,
M.
, and
Holan
,
K.
, 1973, “
Evidence that Supersaturated Bile Is Frequent in Healthy Man
,”
J. Clin. Invest.
0021-9738,
52
, pp.
1467
1479
.
5.
Deenitchin
,
G. P.
,
Yoshida
,
J.
,
Chijiiwa
,
K.
, and
Tanaka
,
M.
, 1998, “
Complex Cystic Duct Is Associated With Cholelithiasis
,”
HPB Surg.
0894-8569,
11
, pp.
33
37
.
6.
Catnach
,
S. M.
,
Anderson
,
J. V.
, and
Trembath
,
R. C.
, 1993, “
Effect of Octreotide on Gallstone Prevalence and Gallbladder Motility in Acromegaly
,”
Gut
0017-5749,
34
, pp.
270
273
.
7.
Bennett
,
D.
,
DeRidder
,
P.
,
Kolozsi
,
W.
,
Gordon
,
R.
, and
Rapp
,
J.
, 1985, “
Cholecystokinin Cholescintigraphic Findings in the Cystic Duct Syndrome
,”
J. Nucl. Med.
0161-5505,
26
, pp.
1123
1128
.
8.
Nakayama
,
F.
, and
van der Linden
,
W.
, 1975, “
Stratification of Bile in Gallbladder and Gallstone Formation
,”
Surg. Gynecol. Obstet.
0039-6087,
141
, pp.
587
590
.
9.
Jazrawi
,
R. P.
,
Pazzi
,
P.
,
Petroni
,
M. L.
,
Prandini
,
N.
,
Paul
,
C.
,
Adam
,
J. A.
,
Gullini
,
S.
, and
Northfield
,
T. C.
, 1995, “
Postprandial Gallbladder Motor Function: Refilling and Turnover of Bile in Health and in Cholelithiasis
,”
Gastroenterology
0016-5085,
109
, pp.
582
591
.
10.
Al-Atabi
,
M. T.
,
Chin
,
S. B.
, and
Luo
,
X. Y.
, 2005, “
Flow Structure in Circular Tubes With Segmental Baffles
,”
J. Flow Visualization Image Process.
1065-3090,
12
(
3
), pp.
301
311
.
11.
Al-Atabi
,
M. T.
,
Chin
,
S. B.
, and
Luo
,
X. Y.
, 2006, “
Visualization Experiment of Flow Structures Inside Two-Dimensional Human Biliary System Models
,”
J. Mech. Med. Biol.
,
6
(
3
), pp.
249
260
.
12.
Al-Atabi
,
M. T.
,
Chin
,
S. B.
, and
Luo
,
X. Y.
, 2006, “
Cystic Duct Visual-Based Evaluation of Gallstones Formation Risk Factors
,”
Journal of Engineering Science and Technology
,
1
(
1
), pp.
1
9
.
13.
Al-Atabi
,
M. T.
,
Chin
,
S. B.
,
Luo
,
X. Y.
, and
Beck
,
S. B. M.
, 2008, “
Investigation of the Flow in a Compliant Idealised Human Cystic Duct
,”
Journal of Biomechanical Science and Engineering
,
3
(
3
), pp.
411
418
.
14.
Li
,
W. G.
,
Luo
,
X. Y.
,
Johnson
,
A. G.
,
Hill
,
N. A.
,
Bird
,
N.
, and
Chin
,
S. B.
, 2007, “
One-Dimensional Models of the Human Biliary System
,”
ASME J. Biomech. Eng.
0148-0731,
129
, pp.
164
173
.
15.
Li
,
W. G.
,
Luo
,
X. Y.
,
Chin
,
S. B.
,
Hill
,
N. A.
,
Johnson
,
A. G.
, and
Bird
,
N. C.
, 2008, “
Non-Newtonian Bile Flow in Elastic Cystic Duct—One and Three Dimensional Modelling
,”
Ann. Biomed. Eng.
0090-6964,
36
, pp.
1893
1908
.
16.
Heister
,
L.
, 1752,
A Compendium of Anatomy
,
Innys and Richardson
,
London
.
17.
Mentzer
,
S. H.
, 1926, “
The Valves of Heister
,”
Arch. Surg. (Chicago)
0004-0010,
13
, pp.
511
522
.
18.
Lichtenstein
,
M. E.
, and
Ivy
,
A. C.
, 1937, “
The Function of the “Valves” of Heister
,”
Surgery
,
1
, pp.
38
53
.
19.
Ong
,
G. B.
, 1962, “
A Study of Recurrent Pyogenic Cholangitis
,”
Arch. Surg. (Chicago)
0004-0010,
84
, pp.
199
225
.
20.
Tanaka
,
M.
,
Ikeda
,
S.
, and
Nakayama
,
F.
, 1984, “
Change in Bile Duct Pressure Responses After Cholecystectomy: Loss of Gallbladder as a Pressure Reservoir
,”
Gastroenterology
0016-5085,
87
, pp.
1154
1159
.
21.
Hallenbeck
,
G. A.
, 1967, “
Biliary and Pancreatic Intraductal Pressures
,”
Handbook of Physiology, Alimentary Canal, Secretion
,
C. F.
Code
, ed.,
American Physiological Society
,
Washington, DC
, pp.
1007
1025
.
22.
Dodds
,
W. J.
,
Hogan
,
W. J.
, and
Geenen
,
J. E.
, 1989, “
Motility of the Biliary System
,”
Handbook of Physiology: The Gastrointestinal System
,
S. G.
Schultz
, ed.,
American Physiological Society
,
Bethesda, MD
, Vol.
1
, pp.
1055
1101
.
23.
Majeed
,
A. W.
,
Smythe
,
A.
, and
Johnson
,
A. G.
, 2006, “
Continuous Ambulatory Manometry of the Human Gallbladder
,” Internal Report, Academic Surgical Unit, The University of Sheffield.
24.
Johnston
,
C. G.
, and
Brown
,
C. E.
, 1932, “
Studies of Gall-Bladder Function: III. A Study of the Alleged Impediment in the Cystic Duct to the Passage of Fluids
,”
Surg. Gynecol. Obstet.
0039-6087,
54
, pp.
477
485
.
25.
MacPherson
,
B. R.
,
Scott
,
G. W.
,
Chansouria
,
J. P. N.
, and
Fisher
,
A. W. F.
, 1984, “
The Muscle Layer of the Canine Gallbladder and Cystic Duct
,”
Acta Anat. (Basel)
0001-5180,
120
, pp.
117
122
.
26.
Roberson
,
J. A.
, and
Crowe
,
C. T.
, 1997,
Engineering Fluid Mechanics
, 6th ed.,
Wiley
,
New York
.
27.
Dodds
,
W. J.
,
Groh
,
W. J.
,
Darweesh
,
R.
,
Lawson
,
T. L.
,
Kishk
,
S.
, and
Kern
,
M. K.
, 1985, “
Sonographic Measurement of Gallbladder Volume
,”
AJR, Am. J. Roentgenol.
0361-803X,
145
, pp.
1009
1011
.
28.
Howard
,
P. J.
,
Murphy
,
G. M.
, and
Dowling
,
R. H.
, 1991, “
Gallbladder Emptying Patterns in Response to a Normal Meal in Healthy Subjects and Patients With Gallstones: Ultrasound Study
,”
Gut
0017-5749,
32
, pp.
1406
1411
.
29.
Bird
,
N. C.
,
Ooi
,
R. C.
,
Luo
,
X. Y.
,
Chin
,
S. B.
, and
Johnson
,
A. G.
, 2006, “
Investigation of the Functional Three-Dimensional Anatomy of the Human Cystic Duct: A Single Helix?
,”
Clin. Anat.
0897-3806,
19
, pp.
528
534
.
30.
White
,
F. M.
, 2004,
Fluid Mechanics
, 5th ed.,
McGraw-Hill
,
New York
.
31.
Bird
,
N. C.
,
Wegstapel
,
H.
,
Chess-William
,
R.
, and
Johnson
,
A. G.
, 1996, “
In Vitro Contractility Stimulated and Non-Stimulated Human Gallbladder Muscle
,”
Neurogastroenterol Motil
1350-1925,
8
, pp.
63
68
.
32.
Luo
,
X. Y.
,
Li
,
W. G.
,
Bird
,
N.
,
Chin
,
S. B.
,
Hill
,
N. A.
, and
Johnson
,
A. G.
, 2007, “
On the Mechanical Behaviour of the Human Biliary System
,”
World J. Gastroenterol.
1007-9327,
13
, pp.
1384
1392
.
33.
Li
,
W. G.
,
Luo
,
X. Y.
,
Hill
,
N. A.
,
Smythe
,
A.
,
Chin
,
S. B.
,
Johnson
,
A. G.
, and
Bird
,
N. C.
, 2008, “
Correlation of Mechanical Factors and Gallbladder Pain
,”
J. of Computational & Mathematical Methods in Medicine
,
9
, pp.
27
45
.
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