SOFT TISSUE SX 9 Flashcards
What are some pre-operative considerations for hepatic surgery?
Hemorrhage, Hypoalbuminemia, Hypoglycemia, Anesthesia, bacteria
Is normal liver flora aerobic or anaerobic?
both
anatomy review: what are the 4 liver lobes?
where does the gallbladder sit?
what vein provides most supply?
Which vessel provides 80% supply to liver?
Which provides remaining 20%?
what are the 3 different techniques for liver biopsies?
briefly compare and contrast them
describle the process of surgical biopsy of a liver
CHECK NOTES AND ADD PICS FOR MORE INFO
What are the 3 types of liver shunts?
A: normal
B: intra-hepatic
C: extra-hepatic
Between large and small breed dogs, which are more likely to ger extrahepatic shunts?
intrahepatic shunts?
extrahepatic: small breed
intrahepatic: large breeds
cats:either
What is the significance of assessing coagulation profiles in hepatic surgery?
Impaired coagulation can lead to hemorrhage, necessitating assessment and possible transfusion support
What is the cause of microhepatica?
occurs when 80% of blood supply is bypassing the liver
What are some systemic effects of portosystemic shunt?
– Failure to thrive
– Hypoalbuminaemia
– Hepatic encephalopathy
– Hypoglycaemia
– Urinary tract signs
* Polyuria / polydipsia
* Urate urolithiasis
– Coagulopath
How can portosystemic shunt be diagnosed?
*liver dysfunction
*high postprandial bile acids
*hyperammonaemia
*signalment
*history
*clinical exam
*biochem changes:
*diagnostic imaging
What are 3 biochem changes that can help diagnose a portosystemic shunt?
what are 4 forms of diagnostic imaging that can be used to diagnose portosystemic shunt?
ultrasound
CT angiography
nuclelar scintigraphy
portovenography
What is the least invasive technique for liver biopsy?
Percutaneous (Ultrasound-Guided)
What are the advantages of laparoscopic liver biopsy?
Less invasive than open surgery, direct visualization, medium sample size
What is the most invasive option for liver biopsy?
Open Surgical biopsy
What are goals for medical management in portosystemic shunts?
=manage hepatic encepalopathy
-decrease oxidative damage to hepatocytes
What are portosystemic shunts (PSS)?
Anomalous vessels that bypass the liver, diverting portal blood into systemic circulation
What is the medical management strategy for hepatic encephalopathy in PSS?
Hepatic diets, lactulose, antibiotics, SAMe
What is the goal of surgical management for portosystemic shunts?
Increase hepatic blood flow by closing the anomalous vessel
What are common postoperative complications following hepatic surgery?
Hypoglycemia,
hemorrhage/anaemia
portal hypertension
seizures, encephalopathy
recurrence of clinical signs
How is the prognosis post PS surgery?
What are surgical indications for the extrahepatic biliary tree?
Biliary obstruction,
biliary trauma,
proximal duodenal resection
What surgical procedures can be performed for biliary issues?
Cholecystectomy, cholecystojejunostomy,
choledochal stenting, choledochotomy
What is the anatomical location of the spleen?
-which quadrant?
-parallel to which structure of the stomach?
Left cranial quadrant, parallel to the greater curvature of the stomach, within the greater omentum
What are the indications for splenic surgery?
Splenic trauma, splenic torsion, splenic neoplasia, benign splenic masses
What are potential complications following splenic surgery?
Hemorrhage, arrhythmias, traumatic pancreatitis, recurrence
What is splenic torsion and its common causes?
Twisting of the spleen; spontaneous torsion is rare but more common in large breed dogs, often secondary to GDV
What are the management steps for splenic torsion?
Treat shock, total splenectomy, prophylactic gastropexy
What is involved in a total splenectomy procedure?
Double ligation and transection of vessels at the hilus or bipolar vessel sealing
