hepato biliary surgery Flashcards
What is the function of CCK and when is it secreted
CCK is produced in the duodenum in response to carbohydrates entering and causes the gallbladder to squeeze and empty
How does bile reach the duodenum
It leaves the gall bladder through the cystic duct and then joins the common hepatic duct to form the common bile duct
What is the composition of gallstones
Mixed between cholesterol and pigment is most common
What are the risk factors for gallstones
- Age
- Gender
- parity and oral contraceptive pill
- High cholesterol
how does gallstones present
- dyspepsia
- biliary colic
- acute cholecystitis
- empyema
- perforation
- jaundice
- gallstone ileus
What is choledocho-lithiasis
Gallstones in the bile duct
What is the presentation of obstructive jaundice
-pain
jaundice
dark urine
pale stool
pruritis
steatorrhoea
What is the treatment for gallstones
- Lithotripsy - shockwave therapy
- Surgical:
- ## cholecystectomy
What is the treatment for a perforated gall bladder
Cholecystotomy - put drain and a tube into the gall bladder
What is the treatment of stones in the common bile duct
ERCP
Describe cholangiocarcinoma
Rare cancer of the bile duct which peaks at 80 years and risk increasing with age - strong association with primary sclerosing cholangitis
What is the presentation of cholangiocarcinoma
obstructive jaundice
Itching
