absite biliary
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| show | contains cystic artery, boundary of liver superior, cystic duct lateral, and CBD medial
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| show | R hep a
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| nml dimensions of CBD, GB wall, pan duct | show 🗑
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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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| what increases biliary excretion | show 🗑
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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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| how does HMGCoA reductase relate to gallstones | show 🗑
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| fxns of bile (3) | show 🗑
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| 2 main types of gallstones and pts | show 🗑
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| 1ry v 2ry gallstones | show 🗑
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| differentiating cholelithiasis v choledocholithiasis | show 🗑
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| show | ERCP
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| tx choledocho v cholelithiasis | show 🗑
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| show | cholecystits-GB distension and wall inflamm 2/2 stones w incrsd WBC and AlkP, but not incrsd bii, Murphys, pain for days v cholelithiasis; choledocho has incrsd bili
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| show | cholangitis has jaundice, F, WBC whereas cholecystitis only low F, minor incrs WBC and no incrs bili
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| show | emergent decompression of biliary tree w ERCP/PTC
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| show | iV Abx and pain, then cholecystectomy
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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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| show | ERCP and sphincterotomy; Bac infxn of bile, usu from portal system, highest incidence from post op stricture (usu E Coli polymicrobial)
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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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| tx gallstone ileus | show 🗑
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| show | if <50% circumference 1ry repair, otherwise hepaticojejunostomy
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| show | U/S to look for bile leak (can perQ drain). If bilious fluid ERCP w sphincterotomy and stent if leak of cystic duct remnant
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| show | hemorrhage from clip falling off cystic a, or late septic shock from clip on CBD leading to cholangitis
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| if stricture s/p lap chole on CBD, do | show 🗑
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| show | MC after lap chole, isch is impt in late post op, also 2/2 chronic pancreatitis commonly seen in chronic EtOH
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| Mgmt porcelain GB? | show 🗑
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| when is lap chole contraindicated (need to do open) | show 🗑
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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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| mgmt PSC | show 🗑
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| PBC: pt type, key serology, tx | show 🗑
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| show | liver trxp or gastric bypass
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| show | compression of c hep duct by extrinsic (stone in cystic duct)
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