ANESTHESIOLOGY FAST REVIEW

ANESTHESIOLOGY_FAST_REVIEWKAPAK1-0-25

HEPATOBILIER PHYSIOLOGY

Gökhan Aslan

İstanbul Arnavutköy State Hospital, Department of Adult Intensive Care Unit, İstanbul, Türkiye

Aslan G. Hepatobilier Physiology. In: Kazancı D, editor. Anesthesiology Fast Review. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.35-43.

ABSTRACT

  • The liver, the largest internal organ in the body, weighs approximately 1300-1500 grams in adults. The liver is surrounded by the Glisson capsule, composed of Type I collagen.
  • The liver is a highly vascularized tissue with dual vascularization by the portal vein and hepatic artery, receiving approximately 25% of cardiac output and acting as a blood reservoir.
  • In the Couinaud model, it is divided into 8 segments with their own separate vascular inflow and outflow and also has an independent drainage system.
  • Located along the sinusoids, Kupffer cells are resident liver macrophages that reach the liver and protect it from bacterial infection, and they play a critical role in maintaining liver function.
  • Hepatocytes facilitate the elimination of drug molecules by converting them into more hydrophilic molecules or compounds through Phase I and Phase II reactions by P450 and other enzymes.
  • Bile contains a number of endogenous solid components dissolved in bile, including bile salts, vitamins, cholesterol, steroids, amino acids, enzymes, heavy metals, and exogenous drugs, xenobiotics, and environmental toxins.
  • The enterohepatic cycle can affect the pharmacodynamics and pharmacokinetics of drugs excreted via bile by decreasing their bioavailability and decreasing or increasing their elimination.

Keywords: Liver; Bile; Hepatocytes; Kupffer cells; Metabolizm

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