Biliary system: anatomy, regulatory mechanisms, and clinical parallels
DOI: 10.32364/2587-6821-2026-10-9-8
Biliary system: anatomy, regulatory mechanisms, and clinical parallels
I.V. Maev1, M.A. Livzan2, G.R. Bikbavova2
1 Russian University of Medicine, Moscow, Russian Federation
2 Omsk State Medical University, Omsk, Russian Federation
The literature review is focused on modern ideas about anatomical and physiological features of the biliary tract which determine nature of a clinical course of biliary tract pathology. Urgency of the issue is due to a steady increase in prevalence of biliary pathology reported in 10–15% of the population of developed countries, and it reaches 20–30% in persons with metabolic syndrome ranking second in gastroenterological morbidity. The review deals with anatomical structure of the intra- and extrahepatic bile ducts, histological structure of the gallbladder wall and sphincter of Oddi. Modern concepts of the mechanisms of bile formation and excretion with an emphasis on the regulatory role of cholecystokinin, motilin and autonomic nervous system are highlighted. Particular attention is paid to pleiotropic biological effects of bile acids, their role in metabolic homeostasis maintenance and a signaling function of farnesoid X-receptors. The paper considers polypotent mechanisms of ursodeoxycholic acid in lipid metabolism, motor function of the gallbladder and cytoprotection. The integration of fundamental data and clinical manifestations makes it possible to justify a differentiated approach to diagnosis and therapy. A final part of the review demonstrates evolution of scientific ideas about conventional risk factors of biliary pathology and reveals molecular mechanisms of their implementation in the light of modern data.
Keywords: biliary tract, anatomy, physiology, bile acids, cholecystokinin, motilin, nocturnal biliary pain.
For citation: Maev I.V., Livzan M.A., Bikbavova G.R. Biliary system: anatomy, regulatory mechanisms, and clinical parallels. Russian Medical Inquiry. 2026;10(9):643–651 (in Russ.). DOI: 10.32364/2587-6821-2026-10-9-8
About the authors:
Igor V. Maev — Dr. Sc. (Med.), Academician of the Russian Academy of Sciences, Professor, Head of the Department of Propaedeutics of Internal Diseases and Gastroenterology, Faculty of General Medicine, Russian University of Medicine; 4, Dolgorukovskaya str., Moscow, 127006, Russian Federation; ORCID iD 0000-0001-6114-564X
Maria A. Livzan — Dr. Sc. (Med.), Corresponding Member of the Russian Academy of Sciences, Professor, Head of the Department of Faculty Therapy and Gastroenterology, Rector of the Omsk State Medical University; 12, Lenin str., Omsk, 644099, Russian Federation; ORCID iD 0000-0001-6581-7017
Galiya R. Bikbavova — Dr. Sc. (Med.), Professor, Department of Hospital Therapy and Endocrinology, Omsk State Medical University; 12, Lenin str., Omsk, 644099, Russian Federation; ORCID iD 0000-0001-9252-9152
Contact information: Galiya R. Bikbavova, e-mail: galiya1976@mail.ru
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 12.07.2026.
Revised 04.08.2026.
Accepted 27.08.2026.
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