absite biliary
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| triangle of Calot | show 🗑
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| show | R hep a
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| show | 8, 4, 4
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| show | ducts of luschka, can leak s/p lap chole
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| how does GB fill | show 🗑
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| show | CCK; morhpine; glucagon
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| show | CCK, secretin (both duo), vagal
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| show | VIP, somatostatin, sympathetic
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| what's stercobilin | show 🗑
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| where is conjugated bili resorbed | show 🗑
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| show | HMGCoA reductase turns HMGCoA into cholesterol, then 7alpha hydroxylase turns into bile acids; in obese ppl stones are due to overactive HMGCoA reductase, in thin due to underactive reductase
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| show | fat soluble vitamin absorption, bilirubin excretion and cholesterol excretion
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| show | nonpigmented (MC, fat, fertile, malabsorb, cf); pigmented incl black (in GB, due to incrsd bili load, decrsd hep fxn, bile stasis, ie hemolytic dz, cirrhosis, ileal resxn, TPN (stasis), ileal resxn); brown (ducts, infxn in Asian E Coli)
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| show | if formed in duct considered 2ry
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| show | cholelithiasis-stone in cystic duct, colicky pain, no murphy no incrsd bili or WBC; choledocho incrsd bili, jaundice but no F or WBC
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| show | ERCP
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| tx choledocho v cholelithiasis | show 🗑
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| differentiating cholecystitis and choledocho | show 🗑
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| differentiating cholecystitis and cholangitis | show 🗑
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| show | emergent decompression of biliary tree w ERCP/PTC
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| mgmt cholecystitis | show 🗑
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| show | ERCP w sphincterotomy and stent
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| show | RUQ pain, F, jaundice (cholangitis)
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| MC organisms cholangitis | show 🗑
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| air in biliary system MC due to | show 🗑
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| show | surgery, TPN, burns/trauma
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| show | gas in GB wall in DM 2/2 C perfringens, hi risk of perf so emergent cholecystectomy
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| where/how does gallstone ileus occur | show 🗑
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| show | enterotomy prox to obstruction, pull out stone, resect the fistula and cholecystectomy
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| show | if <50% circumference 1ry repair, otherwise hepaticojejunostomy
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| if N/V or jaundice s/p lap chole | show 🗑
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| shock s/p lap chole (2 causes) | show 🗑
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| if stricture s/p lap chole on CBD, do | show 🗑
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| causes of CBD strictures | show 🗑
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| Mgmt porcelain GB? | show 🗑
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| show | GB adeno (bc high risk of tumor implants at trocar sites)
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| show | BD cancer (cholangiocarcinoma)
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| RF cholangiocarcinoma | show 🗑
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| show | upper 1/3 (Klatskin) MC unresectable and worst px; middle 1/3 hepaticojejunostomy; lower 1/3 whipple
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| types of pts who get choledochal cysts, types | show 🗑
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| show | hepaticojejunostomy and chole bc risk of cholangiocarcinoma
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| PSC assoc w what, pt types | show 🗑
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| ERCP of PSC shows | show 🗑
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| show | transplant, also cholestyramine and urodeoxycholic acid (decrs pruritis and bile acids respectively)
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| show | seen in women, assoc w scleroderma, no incrsd risk of cancer; anti mito Abs, tx Txp
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| indications for chole for asympt gallstones | show 🗑
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| Mirrizzi syndrome | show 🗑
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