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GI PATHOLOGY > Hepato-biliary surgery > Flashcards

Hepato-biliary surgery Flashcards

1
Q

What is the composition of gallstones?

A

Cholesterol
Pigment
(Mixed) 80%

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2
Q

What are the risk factors for Gallstones?

A

Old
Female
High cholesterol
Pigment (far east)

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3
Q

Presentation of Gallstones

A

Asymptomatic
Dyspepsia - flatulent
Biliary colic

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4
Q

What are some of the complications of Gallstones?

A 
Cholecystitis (upper R quadrant pain)
Empyema
Perforation
Mirrizi's Syndrome
Gallstone ileus
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5
Q

What is Mirrizi’s syndrome?

A

Jaundice associated with pain, fever and rigors

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6
Q

What is choledocholithiasis?

A

Presense of gallstones in the common bile duct

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7
Q

Symptoms of obstructive jaundice

A

Pain
Dark Urine
Pale stool/steatorrhoea
Pruritus

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8
Q

What is Charcot’s triad?

A

PAIN
JAUNDICE
RIGORS

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9
Q

Choledocholithiasis is a common cause of what?

A

Post-cholecystectomy pain

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10
Q

What are the rare but serious complications of choledocholithiasis

A 
Ascending cholangitis (biliary tree sepsis)
Acute pancreatitis
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11
Q

Investigations for gallstones

A 
LFTs
Amylase, Lipase
WCC
USS
CT Scan
MRCP/ERCP
PTC
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12
Q

Treatment for asymptomatic gallstones

A

None

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13
Q

What is the gold standard treatment for gallstones

A

Laparoscopic cholecystectomy

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14
Q

How are cystic bile duct stones managed?

A

Laparoscopic/open exploration of the Common bile duct

ERCP

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15
Q

What are the common congenital causes of biliary tract disease?

A

Biliary atresia

Choledochal cysts

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16
Q

What are the common causes of benign biliary tract stricture?

A

Iatrogenic
Gallstone-related
Inflammatory

17
Q

What classification is used for iatrogenic bile duct injury?

A

Strasberg classification

18
Q

What is primary sclerosing cholangitis?

A

Scarification of the biliary tree

19
Q

PSC increases the risk of what?

A

Cholangiocarcinoma

20
Q

The majority of cholangiocarcinomas occur where?

A

Hilar extrahepatic (67%)

21
Q

Jaundice can be caused by which cancers of the biliary tract?

A

Cholangiocarcinoma

Cancer of the pancreatic head

22
Q

Risk factors for cholangiocarcinoma?

A 
>80
PSC
Congenital cystic disease
Biliary-enteric drainage
Contras
Hepatolithiasis
23
Q

What are the three types of intrahepatic cholangiocarcinoma?

A

Mass forming
Peri-ductal
Intra-ductal

24
Q

Presentation of cholangiocarcinoma

A

Painless obstructive jaundice
Itching
Non-specifics

25
Q

Investigations for cholangiocarcinoma?

A

Radiology (USS, EUS, MRCP, FDG PET)
ERCP
Cytology

26
Q

Management of cholangiocarcinoma

A

SURGERY

Palliative

27
Q

How is gallbladder cancer detected early?

A

Incidental in gallstones

28
Q

Treatment options for ampullary tumours

A

Excision

GI PATHOLOGY (20 decks)

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