Journal of Medical Engineering & Technology

ISSN: 0309-1902 (Print) 1464-522X (Online) Journal homepage: http://www.tandfonline.com/loi/ijmt20

Measurement of the mechanical properties of the

human gallbladder

Alireza Karimi, Ahmad Shojaei & Pedram Tehrani

To cite this article: Alireza Karimi, Ahmad Shojaei & Pedram Tehrani (2017): Measurement of the
mechanical properties of the human gallbladder, Journal of Medical Engineering & Technology,
DOI: 10.1080/03091902.2017.1366561

To link to this article: http://dx.doi.org/10.1080/03091902.2017.1366561

Published online: 29 Aug 2017.

Submit your article to this journal

Article views: 11

View related articles

View Crossmark data

Full Terms & Conditions of access and use can be found at

http://www.tandfonline.com/action/journalInformation?journalCode=ijmt20

Download by: [Australian Catholic University] Date: 12 September 2017, At: 03:59
 JOURNAL OF MEDICAL ENGINEERING & TECHNOLOGY, 2017
https://doi.org/10.1080/03091902.2017.1366561

RESEARCH ARTICLE

Measurement of the mechanical properties of the human gallbladder

Alireza Karimia, Ahmad Shojaeib and Pedram Tehranic
a
Department of Mechanical Engineering, Kyushu University, Fukuoka, Japan; bBasir Eye Health Research Center, Tehran, Iran;
c
Department of Mechanical Engineering, Islamic Azad University, Central Tehran Branch, Tehran, Iran

ABSTRACT ARTICLE HISTORY

Gallbladder is a small organ of the body which is located in the right side of the liver. It is Received 16 May 2017
responsible of storing the bile and releasing it to the intestine. The gallbladder can subject to Revised 2 August 2017
the mechanical deformation/loading as a result of the cholecystitis, cholesterolosis of the gall- Accepted 8 August 2017
bladder, etc. However, so far the mechanical properties of the human gallbladder have not been Published online 30 August
2017
measured. This study was aimed at conducting an experimental study to measure the mechan-
Downloaded by [Australian Catholic University] at 03:59 12 September 2017

ical properties of the human gallbladder under the axial and transversal tensile loadings. To do KEYWORDS
that, the gallbladder tissue of 16 male individuals was excised during the autopsy and subjected Gallbladder; axial and
to a series of axial and transversal loadings under the strain rate of 5 mm/min. The amount of transversal loadings;
elastic modulus as well as the maximum/failure stress of the tissues were calculated via the mechanical properties;
resulted stress–strain diagrams and reported. The results revealed that the axial and transversal elastic modulus
elastic modulus were 641.20 ± 28.12 (mean ± SD) and 255 ± 24.55 kPa, respectively. The amount
of maximum stresses was also 1240 ± 99.94 and 348 ± 66.75 kPa under the axial and transversal
loadings, respectively. The results revealed a significantly higher axial stiffness (p < .05, post hoc
Scheffe method) compared to the transversal one. These findings have implications not only for
understanding the axial and transversal mechanical properties of the human gallbladder tissue,
but also for providing a diagnosis tool for the doctors to have a suitable threshold value of the
healthy gallbladder tissue.

1. Introduction only be used for comparative studies. Genovese et al.

quantified the regional mechanical properties of a
The gallbladder is a small organ of the body located
lamb gallbladder [8]. The age-related alterations in the
in the right side of the liver. It is responsible of storing
gallbladder contractility and gallbladder were meas-
and releasing the bile into the small intestine [1,2].
ured for the guinea pig [9]. Dynamic mechanical prop-
There are some diseases in the gallbladder which can
erties of the gallbladder’s baboon were measured [10].
subject it to the mechanical deformation/loading.
However, so far there is a paucity of data on the
Inflammation of the gallbladder (cholecystitis) can
mechanical properties of the human gallbladder to
block the duct with gallstones and increase the accu-
regardless of the healthy or diseased one.
mulation of the bile [3]. Cholesterolosis of the gallblad-
This study was aimed at measuring the mechanical
der also enables to alter the mechanical properties of
properties of the human gallbladder under the axial
the gallbladder wall on the grounds of the excess
and transversal loadings. The elastic modulus as well
cholesterol [4,5].
as the maximum/failure stress of the gallbladder tis-
Understanding the mechanical properties of the
sues were calculated from the resulted stress–strain
biological tissues is of great importance since it has a
diagrams and then compared under both loading
pivotal role in the function of the organs in the body
directions.
[6]. Investigating the mechanical properties of the soft
biological tissues will provide a deep outlook about
the mechanotransduction of the tissues when subject 2. Materials and methods
to various types of the mechanical loadings [7]. So far,
2.1 Gallbladder tissue preparation and mechanical
the results on the mechanical properties of the gall-
measurements
bladder have all been related to the animal models. It
is known that the mechanical properties of the animal After getting the consent from the donors’ family
tissues cannot be used for the human ones and it can under the ethical rule adhered to the declaration of

CONTACT Alireza Karimi karimi@kyudai.jp Department of Mechanical Engineering, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395,
Japan
ß 2017 Informa UK Limited, trading as Taylor & Francis Group
 2 A. KARIMI ET AL.

the Helsinki in 2008, 16 gallbladders from human

cadavers were excised for the mechanical measure-
ments. The mean age of the donors was
69.28 ± 9.76 years old. The reason of death among the
donors was all related to the diseases which have
nothing to do with gallbladder, such as the cancer,
heart attack, trauma, etc.
After the death of the individuals, the gallbladder
was excised form the body and kept into a special
package made for transportation of the transplanted
organs at 4
C. The gallbladder was transported into
the mechanical testing laboratory and washed by solu-
tion of 0.90% w/v of NaCl with the temperature of
4–5
C to remove the blood. Using the surgical scalpel,
the tissues were cut into the proper size for the tensile
Downloaded by [Australian Catholic University] at 03:59 12 September 2017

testing. The tissue samples were cut along the axial

and transversal directions to help us to measure their
directional mechanical properties. To diminish the tis-
sue degradation, the specimens were all cut as soon
as possible, rather each specimen was tested first and
then another specimen was extracted and cut. This
procedure although took so much time from us, was
important to prevent the tissue from losing some
degree of its stiffness and prevent dehydration.
The sample was then mounted among the jaws of
the machine for the tensile testing as presented in
Figure 1.
The commercial testing machines were equipped
with 50 kgf load cells (DBBP-50, Bongshin Company,
Seongnam, Korea) to provide a very accurate load
measurement for further calculations. All tests were
carried out at room temperature of 22
C and the
humidity level of 52% (AcuRite, CA, USA). Although
the authors did their best to provide the most suit-
able condition of testing to minimise the effect of
tissue degradation and experimental time, the condi-
tions of testing, that is temperature, humidity, etc.,
obviously were not totally as similar as the condition
of the human body. This might be considered as
one of the limitations of this study. In order to make
sure the secure, no slip boundary between the jaws
of the machine and the gallbladder tissue samples
during the tensile testing, the coarse sand papers
were mounted between the interaction site of the
Figure 1. The gallbladders were removed from the fresh
human cadavers within 5 h post-mortem and kept in a special
package to be transferred to experimental setup room. The
gallbladders were put on the table and were washed by solu-
tion of 0.90% w/v of NaCl with the temperature of 4–5
C to
remove the blood on it. The tensile test on the gallbladder tis-
sues was carried out in a way that the lower jaw was kept in
the tissue while the upper jaw was moved at a loading rate.
The CCD cameras meanwhile recorded the deformation of the
markers on the tissue under the deformation in association to
the applied load.
to the tissue samples with the rat of 5 mm/min up
to the failure point. The deformation of the samples
was also measured through three Charged Coupled
Device (CCD) high speed video camera (Sony
Corporation, Tokyo, Japan) [11,12]. The video cameras
are enable to capture 280 frame/s with the reso-
lution of 2048  1088 pixels which provide very
accurate data for further processing. The basic prin-
ciple for the processing work is provided by the
motion analysis software, namely Simi MotionV 2D/
R

tissue and the jaw both in the top and bottom parts
of the testing machine. The thickness of the samples
was measured at least at 15 points of the tissues
and the mean value of that was used (Digimatic
ruler, Insize, Vienna, Austria) for the stress calculation.
Each sample was subjected to five load–unload
cycles to 50% nominal strain at nominal strain rates
of 1 to minimise the viscoelastic effect of the gall-
bladder tissue. Finally, the tensile load was applied
3D (Simi Reality Motion Systems GmbH, Max-Planck-
Strasze, Unterschleiszheim, Germany) [13,14]. This is
the simplest type of test and forms the basis for the
definition of both of (failure stress/maximum stress)
and E (elastic modulus) [15]. The stress within a
material, r, is defined as the tensile force being
applied on a material in both directions, F, divided
by the initial cross-sectional area of the object

normal to the forces, A:
F F
r¼ ¼ (1)
A w  t0
where w and t0 are the width and initial thickness
of the specimen, respectively. At any point during a
uniaxial tensile test, the material’s stress is determined
by how much force the material is being exerted com-
pared to the original cross-sectional area. The failure/
maximum stress is then the maximum force that
objects can tolerate per unit cross-sectional area,
which corresponds to its tensile strength [16]. If
we take the change in length, called the extension,
Dl, and divide this by the original length, l0, we obtain
a quantity called the strain, e, which is often expressed
Downloaded by [Australian Catholic University] at 03:59 12 September 2017
as the percentage change in length.
l  l0 Dl Dl
e¼ ¼ ; or e ¼ 100%
l0 l0 l0
At any given r, an object will extend by some
amount and so will have a particular e. The Young’s
modulus, E, can then be defined as:
dr
E¼ e; t
de
Or the instantaneous derivative of the stress–strain
curve at a specific strain level and time. For an engin-
eering material, stress and strain are linearly related
via the elastic modulus, and are time-independent,
such that the value of E is constant [11]. The resulted
axial and transversal stress–strain diagram of the
gallbladder tissue under the loading is indicated in
Figure 2. The amount of the elastic modulus as well as
Figure 2. The uniaxial tensile stress–strain diagrams of the gallbladder tissues under the axial and transversal loadings. The mean-
ing of the axial or transversal loading is interpreted as an image in the inset.
JOURNAL OF MEDICAL ENGINEERING & TECHNOLOGY 3
the maximum stress was also calculated and plotted in
Figure 3.
2.2 Statistical analyses
Data were first analysed by analysis of variance
(ANOVA); when statistical differences were detected,
the post hoc comparisons with the Scheffe method
was employed. The significance among the mechanical
properties of the gallbladder tissues under different
loading directions were reported as Mean ± SD by the
p values of less than .05.
3. Results and discussions
Since the gallbladder is located in the abdominal part
of the body, it is vulnerable to various types of injuries
(2)
as a result of car accident, sports-related trauma, knife
as well as various types of loading as a result of the
gallbladder’s diseases. Therefore, understating its
mechanical properties to be used for different types of
medical and numerical purposes is of great import-
(3) ance. However, so far the reported results on the
mechanical properties of the gallbladder were all
related to the animal tissues while it is known that
the mechanical properties of the animal tissues can
only be used for comparative assessment. Therefore,
this study was aimed to experimentally measure
the axial and transversal mechanical properties of the
fresh human gallbladder under the tensile loading.
The results revealed the axial and transversal
elastic modulus of 641.20 ± 28.12 (Mean ± SD) and
 4 A. KARIMI ET AL.
Downloaded by [Australian Catholic University] at 03:59 12 September 2017
Figure 3. The bargraph represantion of the elastic modulus and maximum stress of the gallbladder tissue under the axial and
trasnversal tensile loadings. The data showed a significant difference between the axial elastic modulus and maximum/failure
stress of the gallbladder tissue compared to the transversal ones (p < .05, post hoc Scheffe method).
255 ± 24.55 kPa, respectively. The amount of maximum
stresses was 1240 ± 99.94 and 348 ± 66.75 kPa
under the axial and transversal loadings, respectively
(Figures 2 and 3). The results revealed a significantly
higher axial stiffness (p < .05, post hoc Scheffe method)
compared to the transversal one.
Although it is known that the mechanical behaviour
of the soft biological tissues is usually viscoelastic,
nonlinear and anisotropic, in the concurrent study
only the linear elastic mechanical properties of the
gallbladder were discussed. Since the main objective
of this study was to provide a deep understanding of
the mechanical response of the fresh human gallblad-
der under the axial and transversal tensile loadings,
only the simple mechanical approach was employed.
The findings of the current study have implications
not only for understanding the mechanical properties
of the human gallbladder tissue under the tensile
loading, but also for providing a raw data for both the
doctors and engineers to be used for diagnosis and
simulation purposes.
4. Conclusions
Due to the importance of the gallbladder and its
anatomical location in the body, it can subject to
various directional mechanical deformations. In this
study, we aimed at understanding the mechanical
response of the human gallbladder tissue under the
axial and transversal tensile loadings. To do that, the
gallbladder of 16 male cadavers was subjected to
the series of tensile loadings. The elastic modulus as
well as the maximum/failure stress of the tissues
were calculated from the resulted stress–strain dia-
grams and were compared. The findings revealed
that the gallbladder is significantly stiffer under the
axial loading direction compared to the transversal
one. The results of this study have implications for
knowing the directional tensile mechanical properties
of the human gallbladder tissue to be used not
only for simulation and numerical purposes but also
for doctors and medical experts for diagnosis
purposes.
Acknowledgement
Thanks to the Basir Eye Health Research Center.
Ethical issues
The use of experimental on the human body was approved
by the committee of the Iranian Legal Medicine Organisation
(LMO) with the letter ID of 65987/253. This study was also
entirely adhered to the declaration of the Helsinki in 2008
and committee approval of Baghyatallah University of
Medical Sciences, Baghyatallah Hospital, Tehran, Iran. The
experimental study was entirely carried out in Iran under the
above permissions. Since the first author, namely Alireza
Karimi, now works under the affiliation of Kyushu University,
the mentioned affiliation was assigned to this author. All
rights and responsibilities of the experimental human studies
are under the supervision of Iranian Legal Medicine
Organisation.
Disclosure statement
No potential conflict of interest was reported by the authors.

Funding
This research received no specific grant from any funding
agency in the public, commercial or not-for-profit sectors.
References
[1] Ivy AC. The physiology of the gall bladder. Physiol
Rev. 1934;14:1–102.
[2] Nelson DK, Glasbrenner B, Dahmen G, et al. M1 mus-
carinic mechanisms regulate intestinal-phase gallblad-
der physiology in humans. Am J Physiol.
1996;271:G824–GG30.
[3] Barie PS, Eachempati SR. Acute acalculous cholecyst-
itis. Acute cholecystitis. Munich, Germany: Springer;
2015. p. 187–196.
[4] Wang J-M, Wang D, Tan Y-Y, et al. Pioglitazone
reduces lipid droplets in cholesterolosis of the gall-
Downloaded by [Australian Catholic University] at 03:59 12 September 2017
bladder by increasing ABCA1 and NCEH1 expression.
Mol Cell Biochem. 2015;399:7–15.
[5] Dairi S, Demeusy A, Sill AM, et al. Implications of gall-
bladder cholesterolosis and cholesterol polyps? J Surg
Res. 2016;200:467–472.
[6] Fung Y-C, Biomechanics: mechanical properties of liv-
ing tissues. Pittsburgh, USA: Springer Science &
Business Media; 2013.
[7] Humphrey J. Vascular adaptation and mechanical
homeostasis at tissue, cellular, and sub-cellular levels.
Cell Biochem Biophys. 2008;50:53–78.
[8] Genovese K, Casaletto L, Humphrey JD, et al. Digital
image correlation-based point-wise inverse character-
ization of heterogeneous material properties of gall-
bladder in vitro. Proc Roy Soc A: The Roy Soc.
2014;470:20140152.
[9] Poston GJ, Singh P, Maclellan DG, et al. Age-related
changes in gallbladder contractility and gallbladder
JOURNAL OF MEDICAL ENGINEERING & TECHNOLOGY 5
cholecystokinin receptor population in the guinea pig.
Mech Ageing Dev. 1988;46:225–236.
[10] Schoetz D, LaMorte W, Wise W, et al.
Mechanical properties of primate gallbladder:
description by a dynamic method. Am J Physiol.
1981;241:G376G81.
[11] Karimi A, Navidbakhsh M, Rahmani S, et al.
Experimental verification of the healthy and athero-
sclerotic coronary arteries incompressibility via digital
image correlation. Artery Res. 2016;16:1–7.
[12] Karimi A, Shojaei A, Razaghi R. Viscoelastic mechanical
measurement of the healthy and atherosclerotic
human coronary arteries using DIC technique. Artery
Res. 2017;18:14–21.
[13] Karimi A, Rahmati SM, Sera T, et al. A combination of
constitutive damage model and artificial neural net-
works to characterize the mechanical properties of
the healthy and atherosclerotic human coronary
arteries. Artif Organs. 2017. Forthcoming. doi:
10.1111/aor.12855
[14] Karimi A, Navidbakhsh M, Rahmati SM, et al. A com-
bination of experimental and numerical methods to
investigate the role of strain rate on the mechanical
properties and collagen fiber orientations of the
healthy and atherosclerotic human coronary arteries.
Bioengineered. 2016;2:1–17.
[15] Karimi A, Rahmati SM, Razaghi R. A combination of
experimental measurement, constitutive damage
model, and diffusion tensor imaging to characterize
the mechanical properties of the human brain.
Comput Methods Biomech Biomed Eng. 2017.
Forthcoming. doi: 10.1080/10255842.2017.1362694
[16] Karimi A, Shojaei A, Tehrani P. Mechanical proper-
ties of the human spinal cord under the com-
pressive loading. J Chem Neuroanat. 2017;86:
15–18.