Biliary Tract Flashcards
What is the liver covered with?
Glisson’s capsule
Blood supply to the liver?
Portal hepatis Hepatic duct Portal vein branch Hepatic artery branch Nerves Lymphatic s
Why might a hepatic abscess occur?
Spread of bacteria by way of portal system after trauma, through biliary tract, through hepatic artery in septicaemia, and direct invasion.
Why would a hepatic resection be preformed?
Therapy for primary tumours, benign conditions, and metastatic tumours
What r the three approaches to hepatic resection?
Anatomic - malignant cells spread along portal venous supply
Enucleation - pacific benign lesion with little chance of local invasion
Nonanatomic - resection appropriate in which limited margin is acceptable, tumor debulking
What is the blood supply to the gallbladder?
Cystic artery
Two most common reasons for cholecystectomy ?
Cholecystitis
Cholelithiasis
What is a cholangiogram?
Radiopaque contrast medicine injected into common bile or cystic duct, X-rays taken, to check patency of bile ducktail systems
What is choledochojejunostomy and a choledochoduodenostomy?
Anastomosis of common bile duct and jejunum; CBD and duodenum
Why might a choledochojejunostomy be done?
May need to be done after cholecystectomy to bypass an obstruction and re-establish bile flow into intestinal tract.
Blood supply to pancreas?
Celiac axis and superior mesenteric arteries
What are pancreatic cysts?
Collection of pancreatic secretions.
Explain the internal a drainage of a pancreatic cyst.
Into the jejunum (cystojejunostomy)
Into the stomach (cystogastrostomy)
Into duodenum (cystoduodenostomy)
What is a whipped procedure? Why is it done?
Aka pancreaticoduodenectomy Removal of: head of pancreas Duodenum Portion of jejunum Distal third of stomach Lower half of common bile duct and gallbladder
May remove some and not all
Indicated for ducktail carcinoma
What are the surgeries that may be done with a whipple?
Choledochojejunostomy
Pancreaticojejeunostomy
Gastrojejunostomy
When is pancreatic transplantation done?
Pts with type 1 diabetes
May be done with kidney transplant (long term diabetes often associated with renal failure)
Where is the spleen located?
Left upper quadrant
Behind stomach
Protected by 10,11,12 rib
Blood supply to spleen?
Splenic artery
Celiac artery
Splenic vein
