Fisiologi Hepatobiliar

Dr. Shofa Nur Fauzah

Anatomi

Fisiologi Hepar
Bile production Storage Nutrient interconversion Detoxification Phagocytosis

Bile Production
The liver produces and secretes about 6001000 ml Neutralizes and dilutes stomach acid Emulsifies lipids Contain bile pigment (bilirubin) Contain cholesterol, lipids, fat-soluble hormones, lecithin

Storage
Maintaining blood glucose concentrations within normal limits (postprandial) : Remove sugar from the blood Glycogen As the glucose buffer function Store Lipids Store Vitamin A, B12, D, E, K Copper Iron

Nutient Interconversion
Metabolic Pathways Glikoneogenesis converse galactose and fructose Glucosa Glikolisis Glikogen Glukosa Glikogenesis Glukosa Glikogen

Nutient Interconversion
Converts amino acids and two-carbon fragments derived from carbohydrates to fats that can then be transported to adipose tissue for storage. Metabolism and excretion of a wide variety of hormones and other endogenous regulators that circulate in the bloodstream Metabolism of the various steroid hormones such as estrogen, cortisol, and aldosterone.

Detoxification
Hepatocytes express large numbers of cytochrome P450 and other enzymes that can convert xenobiotics, including drugs and toxins, to inactive, less lipophilic metabolites that can subsequently be excreted into the bile and thereby eliminated from the body. Ammonia Urea

Detoxification
Convert xenobiotics phase I metabolism (oxidation, hydroxylation, and other reactions mediated by cytochrome P450's) phase II esterification reactions that link the products to another molecule such as sulfate, glucuronic acid, amino acids, or glutathione including drugs and toxins first-pass metabolism

Phagocytosis
Hepatic Phagocytic cells (kupfer sell) phagocytize dying red, white blood cell, bacteria, debris.

Gallblader
40-70 ml of bile can be stored Water and electrolyte are absorbed Bile salts and pigmen become as much as 510 times more concentrated than they were secreted by the liver