Hepatobiliary Sx-Exam 2 Flashcards
What is the best division of the liver to work in due to lack of gallbladder and blood vessel involvement?
Left division (left medial lobe and left lateral lobe)
T/F: The closer the wound is to the hilus, less likely surgery will be necessary
FALSE- more likely
Why is the entire shock dose not given to a patient with splenic trauma?
Conservative fluid management because we don’t want to disrupt the clot process
Too much fluids will cause high pressure or too much volume
What is the pringle maneuver?
stop the blood flow to the liver and bleeding into the abdomen if it is coming from the liver
Intra-op bleeding control
What a/v are in teh epiploic foramen?
Hepatic a and portal vein
When is a partial lobectomy indicated?
Biopsy, neoplasia, trauma, abscess, cysts
What causes the most blood loss in the liver during partial lobectomy?
Parenchymal fracture and most ligations
When will a liver biopsy be diagnostic?
When you are concerned about lymphoma- otherwise not very dx
What are the liver biopsy methods?
Tru-cut needles
Laparoscopic
Skin punch bx
Guillotine technique
Which liver biopsy method is most helpful when obtaining a sample from the middle of the liver?
Skin punch bx
What is surgicel?
Methylcellulose absorbable sponge that causes hemostasis in local areas
What is cholecystitis?
Inflammation gallbladder
Inflammatory disease, choleliths, choledocholiths, neoplasia, inspissated bile and parasites are examples of what type of biliary obstruction?
Intraluminal
Pancreatic disease and duodenal disease are examples of what type of biliary obstruction?
Extraluminal
What is the name of the procedure when there is an incision into dilated common bile duct?
Choledochotomy
What are the indications for choledochotomy?
Choledochoithiasis or biliary sludge
Why is bile duct stenting most commonly performed?
Relieve obstruction due to extraluminal compression
Temporary diversion of bile after suturing bile duct (can use red rubber catheter)
What is biliary diversion?
Diversion of bile from liver down to intestine
What must be present in order to perform a biliary diversion?
Intact gallbladder
What is the initial size of stoma for cholecystoduodenostomy?
2.5-3 cm
What is a complication in dogs with biliary obstruction?
ascending infection and bleeding at stoma site
What is the main CS of biliary mucocele?
Icterus
Overdistension of gallbladder can result in rupture- this is evident grossly in ___% of cases and>____% in histo cases
50%
70%
What is the common signalment for a patient with biliary mucocele?
Older (9 yrs)
Small/medium dogs
