The biomechanical mechanisms in the formation of hepatic bile duct stones

QU Kai; LIU Chang

doi:10.19538/j.cjps.issn1005-2208.2024.03.04

Abstract：Hepatobiliary stones are one of the most difficult problems facing hepatobiliary surgery in China with high incidence,difficulty treatment,high recurrence rate,and lack of curative treatment method.Previous studies on the formation of hepatobiliary stones have mainly focused on their etiological factors,ignoring the role of biomechanics in the process.However,the mechanical properties of the biliary system are closely related to its physiopathologic functions.From the mechanical point of view,the biliary system is a"pump-tube structure",in which the hepatocyte is the source of bile synthesis,and bile is formed through mechanical osmosis of the capillary bile ducts,then flows through the bile ducts and is discharged into the intestines,with the gallbladder acting as a pump to provide the driving force,and the sphincter of Oddi acting as a valve.The stability of the"pump-tube structure"directly impacts the patency of the bile flow,thereby influencing the formation of hepatobiliary duct stones.Clarifuying the relationship between the mechanical properties of the biliary system and the formation of hepatobiliary duct stones,we can not only gain a deeper understanding of the causes of stone formation but also provide new ideas for future treatment methods.By adjusting the mechanical properties of the biliary system,we may be able to fundamentally prevent the formation of hepatobiliary duct stones,thus paving a new path for the treatment of hepatobiliary duct stones.