Gallbladder & extrahepatic bile ducts

Topic Completed: 1 September 2012

Minor changes: 30 December 2020

Copyright: 2003-2021,, Inc.

PubMed Search: Gallbladder histology[TIAB]

Hanni Gulwani, M.B.B.S.
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Cite this page: Gulwani H Histology-gallbladder. website. Accessed January 16th, 2021.
Definition / general
  • Has mucosa, muscularis propria and serosa on free surface
  • No muscularis mucosa or submucosa is present
  • Variable branching folds, more prominent if gallbladder not distended

Surface epithelium:
  • Composed of single layer of uniform, tall columnar cells with basal nuclei, indistinct nucleoli, pale cytoplasm due to sulfomucins
  • Few PAS+ apical vacuoles; also pencil cells (small, darkly staining columnar cells), inconspicuous basal epithelial cells, T lymphocytes
  • No goblet cells, myoepithelial cells or melanocytes
  • Neck region has tubuloalveolar mucus glands that secrete sulfo, sialo and neutral mucin and contain neuroendocrine cells
  • True glands are not present outside the neck

Lamina propria:
  • Loose connective tissue with blood vessels, lymphatics, occasional chronic inflammatory cells (IgA secreting plasma cells), no neutrophils

Muscular layer:
  • Circular, longitudinal and oblique smooth muscle fibers without distinct layers, resembles muscularis mucosa
  • Adjacent to lamina propria without an intervening submucosa

  • Perimuscular connective tissue composed of collagen, elastic tissue, fat, vessels, lymphatics, nerves, paraganglia

  • Lines gallbladder that is not directly attached to liver, is continuous with that of liver

Aberrant bile ducts (ducts of Luschka):
  • Present in 10% of cholecystectomy specimens, often buried in gallbladder wall adjacent to liver, may contain collar of fibrous tissue, may communicate with intrahepatic bile ducts
  • Histologically composed of lobular aggregates of small ductules lined by bland cuboidal to columnar biliary type epithelium (Am J Surg Pathol 2011;35:883)

Rokitansky-Aschoff sinuses:
  • Outpouchings of gallbladder mucosa that penetrate into muscle wall
  • May be acquired herniations

Larger accessory bile ducts:
  • Join with cystic or hepatic ducts, may be present within gallbladder bed

Mucin secreting accessory glands:
  • Prominent near terminus of common bile duct
  • Bile excretion is normally 500 - 1000 ml/day
  • Bile is concentrated 5 - 10x via active absorption of electrolytes accompanied by passive movement of water
  • Cholecystokinin causes gallbladder contraction and release of stored bile into gut
  • Bile is critical for intestinal absorption of dietary fat but the gallbladder is not
  • Bile is 2/3 bile salts, bicarbonate rich, has 3% organic solutes
  • 95% of secreted bile salts is reabsorbed in ileum and returned to liver via portal blood, called enterohepatic circulation of bile salts
  • Cholesterol is eliminated by loss of 0.5 g of bile salts per day>

Bile salts:
  • Cholates, chenodeoxycholates, deoxycholates, lithocholates, ursodeoxycholates
  • Major hepatic products of cholesterol metabolism
  • Family of water soluble sterols with carboxylated side chains
  • Are highly effective detergents, solubilize water insoluble lipids secreted by the liver (usually lecithin) into the biliary tree and promote dietary lipid absorption within the gut

Lecithin (phosphatidylcholine):
  • Hydrophobic, nonaqueous
  • Has minimal solubility in water
Microscopic (histologic) images

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Cross section

Positive stains
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