E2: Hepatobilliary (incl PSS) Flashcards
Between which liver lobes is the gallbladder? In which division?
Quadrate and right medial lobe
Central division
What is the Pringle maneuver? When is it used?
Blocking, digitally or with clamp, the portal vein and hepatic artery (main blood supply to liver) in the epiloic foramen
Way to occlude blood flow to the liver temporarily (for max 10-15 min) to control bleeding
What is a choledolchotomy?
Incision into the gall bladder duct
When could you use the Guillotine technique for a liver biopsy?
When want to biopsy the periphery/margin of a liver lobe
When suspect generalzed disease and want to obtain a large sample
What biopsy techniques would you use for a focal lesion, such as a tumor?
Percutaneous
FNA
What should you make sure is fairly normal in texture and consistency before taking a liver biopsy via Parenchymal Fracture? What is a major disadvantage of this technique?
Liver parenchyma
Disadvantage: if bleeding occurs after hemostats are removed, it can be difficult to control; technique generally associated with greatest amount of blood loss of all biopsy techniques
What type of biopsy would you take if the lesion is more centrally located on the liver lobe? Which surface of the liver should biopsies be taken and why?
Punch biopsy
Convex surface (across from diaphragm), larger vessels are closer to the concave surface
Also do not penetrate more than half the thickness of the lobe
What can you use to control the bleeding after a small biopsy of the liver?
Absorbable gelatin sponge
What techniques can you use to prevent bleeding after a partial lobectomy?
Overlapping sutures
Staples
Surgities
What are some common indications for a partial or complete lobectomy?
Trauma
Infection
Neoplasia
Arteriovenous fistula
What are the 4 main types of neoplasms that are found in the liver?
Hepatocellular
Cholangiocellular
Mesenchymal
Neuroendocrine
What is the most common benign liver neoplasia in the dog? Cat?
Dogs: Hepatoma
Cats: Cholangiocellular adenoma
What malignant neoplasm of the canine liver caries the best prognosis? Worst?
Massive adenocarcinoma of LEFT lobes
Worst: Diffuse
T/F: Metastatic tumors, such as HSA, are more common than primary tumors in the liver.
True
What is the most common cause of extrahepatic biliary tract obstruction in dogs?
Pancreatitis
What dog breeds are predisposed to the development of gallbladder mucoceles?
Shelties
Cocker Spaniels