Hepatobiliary surgery Flashcards
What is the function of the gallbladder?
to store and concentrate bile
What hormone initiates the gallbladder to secrete?
CCK after a meal
What is cholesterosis?
“strawberry gallbladder”
excess cholesterol
What are gallstones made of?
cholesterol + pigment
Who is more likely to have gallstones? (male or female)
females (9:1)
What are the risk factors for cholesterol gallstones?
obesity, CF, ileal disease and cirrhosis
What are the risk factors for pigment gallstones?
bile infection
How are some ways a patient may present?
incidentally
empyema, dyspepsia, perforation, biliary colic, acute choleycystitis, jaundice
What is Mirrizi’s syndrome?
When a gallstone becomes impacted in the cystic duct or gallbladder causing compression of the common bile duct or common hepatic duct leading to obstruction and jaundice
What is choledolithiasis?
Presence of a gallstone in the common bile duct
What are the symptoms of choledolithiasis?
obstructive painful jaundice, dark urine, steathorrea and pale stool and pruiritis
What is charcot’s triad?
RUQ pain, jaundice and fever
What are some investigations of gallstones?
blood - LFT, AST, ALT, amylase, WCC, CRP, lipase
USS, EUS, CT, ERCP,
What are some non operable treatments of gallstones?
Flush them out by the kidneys using dissolution or try and break them up to be excreted
Describe the difference between open, mini, laparascopic and single port cholecystectomy
open - large incision no longer done
mini - using special retractors
laparascopic - routinely done 4 holes 1 for camera and 3 for instruments
single port - through umbilicus
