Surgery of the Biliary Tract, Pancreas, Liver, and Spleen Flashcards
A trumpet-mouthed dilatation of the duodenal wall at the opening of the fused pancreatic and common bile ducts.
Ampulla, or papilla, of Vater
Manufactured by the hepatocytes of the liver. Contains bile salts, which facilitate digestion and absorption and various waste products.
Bile
Removal of the gallbladder; performed for the treatment of diseases such as acute or chronic inflammation or stones
Cholecystectomy
Inflammation of the gallbladder
Cholecystitis
Establishes an opening into the gallbladder to drain the organ and remove stones.
Cholecystostomy
Stone formation in the gallbladder.
Cholelithiasis
A disease of the liver in which the tissue hardens and the venous drainage becomes blocked. It usually is caused by chronic alcoholism but may result from other disease conditions.
Cirrhosis
A descriptive term for tissue that means fragile and easily torn, and may bleed profusely. Some disease states produce this type of tissue. The liver and spleen normally are in this state.
Friable
The external covering of the liver composed of this dense connective tissue (visceral peritoneum) that extends over the entire surface of the liver, except at the point of posterior attachment to the diaphragm.
Glisson’s Capsule
Glisson’s Capsule is the external covering of the liver composed of this dense connective tissue (visceral peritoneum) that extends over the entire surface of the liver, except at the point of posterior attachment to the ________.
diaphragm
A small tube (catheter) is placed into the cystic duct, which drains bile from the gallbladder into the common bile duct. A dye that blocks X-rays is injected into the common bile duct and then X-rays are taken. This procedure is done to look for gallstones that may be in the common bile duct or to allow the surgeon to see the anatomy of the bile duct system from the liver to the small intestine.
Intraoperative Cholangiogram
Surgical removal of one or more anatomical sections of the liver.
Lobectomy
Excision of a segment of an organ (for example the excision of a portion of a lobe of a lung aka “segmentectomy”)
Segmental Resection
Contains the cystic artery (and possibly the right hepatic artery) and is a landmark in surgical removal of the gallbladder. Its boundaries may be remembered as “the 3 Cs”: Cystic duct, Common hepatic duct, and Cystic artery.
Triangle of Calot
Pancreatic transplant patients may remain on immunosuppression drugs postoperatively for:
indefinitely
A patient with end-stage liver disease caused by biliary artesia will require what procedure in conjunction with their liver transplant?
choledochoenterostomy
The pancreas lies directly on top of what two blood vessels?
Superior mesenteric artery and vein
Severe portal hypertension, uncorrectable coagulopathy, severe ascites, extensive adhesions, uncorrectable coagulopathy, extreme splenomegaly, most traumatic injuries to the spleen, are all contraindications for ________.
laparoscopic splenectomy
What is the most common nonemergent abdominal surgery performed today?
Cholecystectomy
A cholangiogram setup must be free of bubbles because they might be interpreted as…
gall duct stones on the x-ray film.
Any procedure in which the alimentary tract is entered under controlled conditions and without unusual contamination is considered a ________ wound. If there is gross spillage, however, the wound is classified as ________. Proper wound classification is considered an important predictor of ________.
clean-contaminated
contaminated
postoperative SSI (surgical site infection)
The ________ procedure is the removal of the head of the pancreas, the entire duodenum, a portion of the jejunum, the distal third of the stomach, and the lower half of the common bile duct.
Whipple
________ surgical wounds show no signs of inflammation and do not involve the respiratory, gastrointestinal or genitourinary tracts. Laparoscopic surgeries, surgeries involving the skin (such as biopsies), eye or vascular surgeries are good examples.
Clean
________ wounds are clean wounds with a higher risk of infection such as those involving the gastrointestinal, respiratory or genitourinary tracts, as long as the surgery is uncomplicated. Any wound opened to remove pins or wires, chest procedures, ear surgeries or gynecologic procedures are considered this type of wound.
Clean-contaminated
Surgical Anatomy-
The ________ is in the right upper
quadrant of the abdominal cavity, beneath the dome of the diaphragm and directly above the stomach, duodenum, and hepatic flexure of the colon.
liver
________ surgical wounds include those with a foreign object lodged in the wound (such as a bullet or other debris). This class also includes traumatic wounds from a dirty source where the treatment was delayed, infected surgical wounds or any wound that has been exposed to pus or fecal matter.
Dirty-infected
A ________ incision is used for surgical procedures of the liver.
midline
A ________ incision is used for surgical procedures of the pancreas.
.paramedian
A ________ incision is used for surgical procedures of the spleen.
midline, occasionally subcostal
Chemical hemostatic agents that may be used during surgery of the biliary tract (6):
Absorbable gelatin
Collagen
Oxidized cellulose
Epinephrine
Thrombin
Dermabond
Thermal hemostatic agents that may be used during surgery of the biliary tract (4):
Electrosurgical unit (monopolar and/or bipolar)
Harmonic scalpel
Argon beam coagulator
Smoke evacuator
Which structure is identified and divided during a Cholecystectomy?
Cystic duct