Procedure Flashcards
1
Q
Ports location and size for laparoscopic cholecystectomy
A
> Hasson technique
- 5-12mm Hasson trocar at umbilicus
- 3 additional port at 1-2cm below right costal margin
( 5-12mm inferior to xiphoid process, 5mm inferior to midclavicular line, 5mm inferior to anterior axillary line)
2
Q
Complication of laparoscopic cholecystectomy
A
- Gallbladder perforation (During dissection, cause spillage of bile)
- Vascular injury (Cystic artery)
- Bowel perforation
- Mesenteric injuries
- Bile duct injuries
3
Q
How to remove stone in ERCP
A
- Dormia basket
- Mechanical lithotripsy
- Balloon
4
Q
How to prepare patient for ERCP
A
- Fasting for >=4 hours prior
- Monitor baseline vital signs
- Notify endoscopist if allergic to contrast (steriods/ antihistamine/ non-ionic contrast)
- FBC/ PT/INR/ LFT (<72 hours) reviewed
- Recent imaging studies should be available (US/ CT/ MRI/ EUS)
5
Q
Complication of ERCP and how to manage
A
- Duodenal perforation (Require surgery or further therapy through the endoscope)
- Hemorrhage (Stopped through endoscope)
- Pancreatitis (Pain relief, usually settles over next 24-48 hours)
- Sepsis/ cholangitis (Antibiotics)