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GI System > Hepato-Biliary Surgery > Flashcards

Hepato-Biliary Surgery Flashcards

1
Q

What are three functions of the gallbladder?

A

Bile reservoir
Concentrates bile
Secretes CCK after meal

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2
Q

What are the two benign conditions related to gallbladder disease?

A

Cholesterosis

Gallbladder polyps

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3
Q

What are gall stones made of?

A

Mixed - 80% of them

Cholesterol & Pigment - 20% of them

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4
Q

What are the risk factors for gall stones?

A 
Age
Gender
Parity = OCP (4F)
Cholesterol
Pigment
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5
Q

What are the presentations of gall stones? (8)

A 
Asymptomatic
Dyspeptic symptoms
Biliary colic
Jaundice
Acute cholecystitis
Empyema
Perforation
Gallstone ileus
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6
Q

What is choledocho-lithiasis?

A

The presence of at least one gallstone in the common bile duct

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7
Q

What issues can arise from gallstones?

A 
Primary vs Secondary
Incidental at cholecystectomy
Post-cholecystectomy pain
Obstructive jaundice
Acute pancreatitis
Ascending cholangitis (Charcot's triad)
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8
Q

What investigations must be done for gallstones?

A 
Bloods
USS
EUS
Oral cholecystography
CT
Radio isotope scan
IV Cholangiography
MRCP
PTC
ERCP
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9
Q

What are the management options for gallstones?

A

Non-operative - Dissolution & Lithotripsy

Operative - Any type of cholecystectomy

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10
Q

How are bile duct injuries classified?

A

Strasberg classification

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11
Q

What are the two types of congenital benign biliary tract disease?

A

Biliary atresia

Choledochal cysts

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12
Q

What types of benign biliary stricture are there?

A

Iatrogenic
Gallstone related (Mirrizi’s)
Inflammatory - HIV, Pyogenic, Parasitic, PSC & Pancreatic

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13
Q

What percentage of Cholangiocarcinoma are intra/extrahepatic?

A

Intrahepatic - 6%

Extrahepatic - 94%

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14
Q

What are the types of intrahepatic tumuor?

A

Mass forming
Peri-ductal
Intra-ductal

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15
Q

What are the types of extrahepatic tumour?

A

Hilar

Distal

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16
Q

What are the three treatment options for malignant ampullary tumours?

A

Endoscopic excision
Trans-duodenal excision
Pancreatico-duodenectomy

17
Q

What is a cholangiocarcinoma?

A

Form of cancer that is composed of mutated epithelial cells that originate in the bile ducts which drain bile from the liver into the small intestine

18
Q

What are the six risk factors for cholangiocarcinoma?

A 
PSC
Congenital cystic disease
Biliary-enteric drainage
Thorotrast
Hepatolithiasis
Carcinogens
19
Q

How do cholangiocarcinomas present?

A

Obstructive jaundice
Itching
Non-specific symptoms

20
Q

What investigations should be done for cholangiocarcinoma?

A 
Lab
Radiology
ERCP
Cholangioscopy
Cytology
21
Q

What management options should be looked at for cholangiocarcinoma?

A

Surgical - Potential cure

Palliative - Priority is too remove jaundice

GI System (38 decks)

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