Luo Xiaoyu, Li Wenguang, Bird Nigel, Chin Swee Boon, Hill N A, Johnson Alan G
Department of Mathematics, University of Glasgow, Glasgow, G12 8QW, United Kingdom.
World J Gastroenterol. 2007 Mar 7;13(9):1384-92. doi: 10.3748/wjg.v13.i9.1384.
This paper reviews the progress made in understanding the mechanical behaviour of the biliary system. Gallstones and diseases of the biliary tract affect more than 10% of the adult population. The complications of gallstones, i.e. acute pancreatitis and obstructive jandice, can be lethal, and patients with acalculous gallbladder pain often pose diagnostic difficulties and undergo repeated ultrasound scans and oral cholecystograms. Moreover, surgery to remove the gallbladder in these patients, in an attempt to relieve the symptoms, gives variable results. Extensive research has been carried out to understand the physiological and pathological functions of the biliary system, but the mechanism of the pathogenesis of gallstones and pain production still remain poorly understood. It is believed that the mechanical factors play an essential role in the mechanisms of the gallstone formation and biliary diseases. However, despite the extensive literature in clinical studies, only limited work has been carried out to study the biliary system from the mechanical point of view. In this paper, we discuss the state of art knowledge of the fluid dynamics of bile flow in the biliary tract, the solid mechanics of the gallbladder and bile ducts, recent mathematical and numerical modelling of the system, and finally the future challenges in the area.
本文综述了在理解胆道系统力学行为方面所取得的进展。胆结石和胆道疾病影响着超过10%的成年人口。胆结石的并发症，即急性胰腺炎和梗阻性黄疸，可能会致命，而患有非结石性胆囊炎疼痛的患者常常在诊断上存在困难，需要反复进行超声扫描和口服胆囊造影。此外，为缓解这些患者的症状而进行的胆囊切除术，效果不一。为了解胆道系统的生理和病理功能，已经开展了广泛的研究，但胆结石的发病机制和疼痛产生的机制仍知之甚少。人们认为，力学因素在胆结石形成和胆道疾病的机制中起着至关重要的作用。然而，尽管临床研究文献丰富，但从力学角度研究胆道系统的工作却很有限。在本文中，我们将讨论胆道胆汁流动的流体动力学、胆囊和胆管的固体力学、该系统最近的数学和数值建模，以及该领域未来面临的挑战。
