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Flashcards in BILIARY Deck (8)
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1

During a laparoscopic cholecystectomy an injury to the common bile duct occurs and is
recognized. This situation requires

conversion to a laparotomy and cholangiography.

If the injured segment of bile duct is short (

2

Drainage and pre-op temporizing for patent with CBD injury after lap chole

PTC with catheter drainage to determine level of injury and

***leave catheter tip****

at injury site to assist with intra-operative identification

3

Postcholecystectomy syndrome

Can present with right upper quadrant pain post cholecystectomy

Need a good history including alcohol abuse

Get upper endoscopy and ERCP

If you suspect sphincter of OD dysfunction duodenal pressure can be measured to diagnose sphincter oh any spasm or stenosis

May require sphincterotomy

4

Choledochal cyst

Types and surgeries for them

5

Pancreatic ascites

Emily's is very high and me be from leaking pseudocyst or pancreatic duct

Initial treatment is conservative:
NPO TPN
Octreotide 150 mg sub queue queue eight hours or drip
Repeat abdominal taps

May need ERCP with center out of me and possible stent

6

Treatment pink relativism

Non-fusion of the Long dorsal duct main dark in the short ventral dart

Also the main duct usually drains via the minor papilla instead of the normal anatomy and the minor papilla can be overwhelmed

Diagnosed with ultrasound and give secretin injection to see if dorsal duct dilation response with the patient's pain

Give ERCP and have them stand the dorsal duct

May require dorsal duct plasty

7

24-year-old female with the gallstone polyp that is 7 mm ultrasound sound performed in six months later this his 9 mm

What is the management

Laparoscopic cholecystectomy

Consider open cholecystectomy and frozen section

8

Laparoscopic cholecystectomy is performed and there is muscular invasion

What is the management

Radical cholecystectomy

Liver segments 4b and 5

Portal notes

Cystic duct margin

Port site excision