20 Flashcards
gallbladder sits between the
quadrate and right medial liver lobes
extra hepatic biliary tract obstruction EHBO falls into 3 catagories
Extraluminal
− Pancreatitis, neoplasia
Intraluminal
− Cholelithiasis, GB mucocele, foreign body, neoplasia
Intramural
− Neoplasia
why do pt feel sick from bile flow obstruction
decrease in bile salts in intestion= bacteria will start to overgrow
most are gram neg and will release endotoxins that will make pts sick
gallbladder mucocele will have — on biopsy
cystic mucinous hyperplasia
* thick gel like shiny green/black congealed bile
gallbladder
kiwi bladder= biliary mucocele
if bile is leaking, abdominocentesis will have bilirubin — then serum
greater than 2x
- surgical emergency!
how to flush bile duct
antimesentaric duodenotomy 3-6 cm after the pyloris
- this is where common bile duct will enter at major papilla
— is incision into the bile duct
choledochotomy
removal of gallbladder
cholecystectomy
where to ligate gallbladder if you are removing it
above where the hepatic ducts empty, want to ligate at the cystic ducts
why do cholecystoenterostomy
when you cant use the bile ducts and there is still a healthy GB, such as pt with pancreatic cancer
when doing surgery on gallbladder what other things can you do at same time
culture bile/gallbladder
liver biopsy
place feeding tube if needed
how to treat biliary mucocele
cholecystectomy and flush bile duct
sick dog, dilated CBD and biliary mucocele and mild peritoneal fluid and inflammation around GB
how to treat
gallbladder rupture
- cholecystectomy, flush and lavage
2 weeks decreased appetite and 2 days of anorexia, 1-2 times daily vomiting
* BW – increased ALP and bilirubin
* US – severe pancreatitis with an
enlarged GB
how to treat
pancreatitis
* biliary stent
* cholecystoenterostomy- attach GB to intestine
* chyolecystostomy tube- tube from GB out of body
