Hepato-biliary surgery

Question 1

What does the gallbladder do?

Answer 1

Stores and concentrates bile

Question 2

What size of gallbladder polyp is irrelevant?

Answer 2

<0.5cm

Question 3

What size of gallbladder polyp should always be removed?

Answer 3

> 1cm

Question 4

What are some factors of gallstone presentation?

Answer 4

Biliary colic (dull pain in upper right quadrant)
Acute cholecystitis
Empyema
Perforation
Jaundice

Question 5

What are some features of acute cholecystitis?

Answer 5

Fever
Raised LFD
Rigors

Question 6

What is a primary gallstone?

Answer 6

One which comes from the bile duct

Question 7

What is a secondary gallstone?

Answer 7

One which drops from gallbladder into cystic duct

Question 8

What other conditions may a gallstone lead to?

Answer 8

Acute pancreatitis

Obstructive jaundice

Question 9

What is the best investigation for gallstones?

Answer 9

Abdominal ultrasound

Question 10

How are gallstones managed?

Answer 10

Dissolution
Lithotripsy
Open cholycystectomy
Mini cholycystecotmy

Question 11

Where are cholangiocarcinomas usually found?

Answer 11

Hilar of liver

Question 12

How does cholangiocarcinoma present?

Answer 12

Obstructive jaundice

Itching

Question 13

What are some useful investigations for cholangiocarcinoma?

Answer 13

Lab
USS
EUS
CT
MRA
Angiography
ERCP
Cytology