SA Surgery of the Liver, Gallbladder and Extrahepatic Biliary

Question 1

List three manifestations of hepatic insuffiency

Answer 1

Hypoproteinaemia
Hypoglycaemia
Coagulopathy

Question 2

When are antibiotics indicated in liver surgery and which two antibiotics could you use?

Answer 2

Intravenous peri-operative antibiotics indicated even if only biopsying.
Potentiated amoxycillin/2nd generation cephalosporin

Question 3

List three first-opinion level liver biopsy techniques

Answer 3

Crushing/haemostat technique
Guillotine technique
Biopsy punch

Question 4

What is the main liver mass found in cats that would be an indication for liver lobectomy?

Answer 4

Cystadenoma

Question 5

What is the main liver mass found in dogs that would be an indication for liver lobectomy?

Answer 5

Hepatocellular carcinoma

Question 6

Which side of a liver lobectomy is easier?

Answer 6

Left

Question 7

List four techniques used in liverlobectomy surgery?

Answer 7

Finger fracture
Overlapping mattress suture
Mass ligation
Linear stapler
Vessel sealing device

Question 8

At which anatomical structure does the bile duct enter the duodenum?

Answer 8

Major duodenal papilla

Question 9

Are cats or dogs more susceptible to ascending cholangitis?

Answer 9

Cats

Question 10

List four extrahepatic indications for biliary tract surgery?

Answer 10

Cholelithiasis
Gall bladder mucocele
Pancreatitis
Neoplasia

Question 11

What are the two surgical strategies in bile duct surgery?

Answer 11

Cholecystectomy
Cholecystoenterostomy

Question 12

When would you perform a cholecystectomy?

Answer 12

For treatment of gall bladder disease or traumatic rupture.

Question 13

When would you perform a cholecystotomy?

Answer 13

For removal of choleliths and bile sludge

Question 14

What is a cholecystoenterostomy and what is it used for?

Answer 14

Anastamosis of the gall bladder to the small intestine. Used for complete and irreversible obstruction of the common bile duct or rupture.