Hepatobiliary Flashcards
Right hepatic artery off of ___ in ___%.
SMA in 17% (Every year)
Left hepatic artery off of ___ in ___%
Left gastric artery in 10%
Kupffer cells….
clear portal blood immunosurveillance
Portal triad…
portal vein posterior to CBD (on R) and hepatic artery (on L)
Hepatorenal syndrome…. what lab value?
See low urinary Na
Cholangitis…….symptoms?
jaundice, RUQ tenderness, fever, hypotension, change in mental status
Cholangitis…… what to do?
Needs immediate IV abx, fluid resuscitation and emergent drainage of CBD (Every year)— we said ERCP too….
Retained CBD stone identified on T-Tube cholangiogram 6 weeks postop best managed by _______.
radiology stone retrieval
Benign biliary stricture…………….. cause?
1 cause is iatrogenic (lap chole)
Gallbladder adenocarcinoma:
__% have stones. Cholecystectomy adequate if ____.
If grossly visible tumor, do ___, ____, ____.
90% have stones; chole ok if confined to mucosa; if grossly visible— do regional lymphadenectomy, wedge segment V, skeletonize portal triad
Porcelain gallbladder: ___% risk of cancer.
____ indicated.
30-65%;
cholecystectomy
Hematobilia triad: ___, ____, ____.
Workup and Rx is ________.
GI bleed, jaundice, RUQ pain.
Workup and Rx with arteriogram.
Gallbladder concentrates bile by ________
by active absorption of Na, Cl (H20 then follows)
Hepatic adenoma: ___% rupture/bleed.
Benign or malignant potential? _____.
Hot or cold on liver scan? ____.
Indication for resection? _____.
10% rupture; malignant potential; cold on liver scan; hepatic adenoma IS an indication for resection. (Every year)
Hepatic hemangioma Rx?????
Do nothing unless giant or symptomatic/consumptive.
