Surgical Gall Bladder/Biliary tract

Question 1

Biliary Colic

• Path
• S/S
• Tx

Answer 1

• Path: intermittent Cystic duct obstr by stone
• S/S: N/V; Bloating;
• Tx: Cholecystectomy

Question 2

Acute Cholecystitis

• Path
• S/S
• LabDx
• Tx:

Answer 2

• Path: Cystic duct obstruction w/ or w/out stone by inflammation
• S/S: Murphy’s sign; Abdominal pain, N/V
• LabDx: Ultrasound + PIPIDA/HIDA Scan;
• Tx: Admit; NPO; Abx (Cephazolin /Anceph); Cholecystectomy

Question 3

Percutaneous Cholecystostomy

Answer 3

• Drain placed to drain gallbladder

- Really sick patients who wont survive surgery

Question 4

Biliary dyskinesia

• Path
• Diagnosis
• Tx

Answer 4

• Path: DEC Gallbladder ejection
• CCK PIPIDA
• Tx: Reassurance, anelgesics; Cholecystectomy?

Question 5

Gallbladder Cancer

• Prognosis
• A/S

Answer 5

• Very rare
• Poor 5 yr prognosis
• A/S Porcelain gallbladder (25% risk)

Question 6

CBD Malignancies

S/S

Answer 6

• S/s: Jaundice, RUQ pain
• Adenocarcinoma
• Courvoisier’s sign - nontender gall bladder

Question 7

Klatskin’s tumor

Answer 7

• tumor at bifurcation of hepatic ducts

Question 8

Whipple Operation indications

Answer 8

• Bile Duct Cancer

- Pancreatic cancer