Home
Flashcards
Preview
biliary.txt
Home
Get App
Take Quiz
Create
boundaries of triangle of calot
cystic duct
CBD
Liver
injury during lap chole can result in ischemia to segment VI and VII
aberrant post right hepatic
lymphatics are found where in relation to the cbd
right side
layers not present in gallbladder
submucosas and muscularis mucosa
what are Rokitansky-aschoff sinuses
invagination of epithelium in to muscle layer secondary to increase intraluminal pressure
bile concentrated in gallbladder by
active Na and water reabsorption
ion not increased in bile concentration
chloride
bile salt pool
6 gm and 6 cycles per day
post prandial emptying of GB is maximal when
2 hours
promote calcium nucleation
mucin glycoproteins
black stones seen in
hemolytic d/o
liver disease -cirrhosis/tpn
terminal ileum resection
what is important for the development of black stones
increased bilirubin load
decreased hepatic function
bile stasis
parameters for chronic cholecystitis on HIDA
if the GB takes greater than 60 minutes to empty after a meal
EF needed to diagnose biliary dyskinesia
<40%
highest incidence of positive bile cultures seen with
post op strictures
risk factors for malignacy in gallbladder polyps
size >1cm
age >60
sessile polyps
PSC
charcots triad
ruq pain
fever
jaundice
cholo venous reflux occurs at what pressure
>20mmhg
organisms seen in primary CBD
E coli
Clonorchis sinensis
A lumbricoides
T trichiura
treatment of recurrent pyogenic cholangitis (oriental kind)
ERCP with sphincterotomy and dilation but do not stent
Eventually will need hepaticoJ
which ducts can you ligate
any duct less than 2mm
order of tests for post op N/V, sepsis, jaundice
u/s
drain fluid if present
ERCP if bilious
PTC if this doesnt work
HIDA if small duct
treatment for biliary leak post cholecystectomy
ercp sphincterotomy stent
likely clip on CBD
if greater than 7 days decompress and wait 6-8 weeks
ddx for jaundice
cbd stones or stricture
primary liver disease
hemolysis
tx of hemobilia
angioembolization
what distinguishes a nonresectable biliary CA
LN spread beyond hepatoduodenal ligament
main portal vein or proper hepatic artery invasion
direct invasion of stomach, colon, duodenum, abdominal wall
what pts with cholangiocarcinoma are elligible for a transplant
unresectable <3cm and hilar
surgery for IIa and great gallbladder cancer
cholecystectomy
formal resection of IVb and V
stripping of portal triad
Author
nsmallwood
ID
124199
Card Set
biliary.txt
Description
biliary
Updated
12/17/2011, 7:45:55 PM
Show Answers
Home
Flashcards
Preview