Hepato-Biliary Surgery Flashcards
Under what circumstances would gallstones not be treated?
If asymptomatic and found by coincidence
What are the non-operative treatments for gallstones?
Dissolution - only for patients who are unfit or have significant co-morbidities
Lithiotripsy - no longer widely used as it can break a large stone into multiple small stones
What are the possible surgical treatments for gallstones?
Open cholecystectomy
Laparoscopic cholecystectomy - treatment of choice
Cholecystotomy for severely ill patients
What are the benefits of cholecystotomy?
Allows temporary drainage from the gall bladder in severely ill patients
Has a quick recovery time so cholecystectomy can be done once patient has recovered
How can common bile duct stones be treated?
ERCP or transhepatic stone retrieval
Most will pass by themselves
What are the treatment options for cholangiocarcinoma?
Surgery is the only potentially curative option
Palliative care - bypass, stenting, radio/chemotherapy, PDT
What are the surgical treatments of ampullary tumours?
Endoscopic excision
Trans-duodenal excision
Pancreatico-duodenectomy
