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Questions and Answers
The Sphincter of Oddi is located at the junction of the Common Bile Duct and the Pancreatic Duct.
The Sphincter of Oddi is located at the junction of the Common Bile Duct and the Pancreatic Duct.
True (A)
The Triangle of Calot is a landmark used for the surgical removal of the spleen.
The Triangle of Calot is a landmark used for the surgical removal of the spleen.
False (B)
The Celiac Axis is a major artery that branches into the Common Hepatic, Left Gastric, and Splenic arteries.
The Celiac Axis is a major artery that branches into the Common Hepatic, Left Gastric, and Splenic arteries.
True (A)
The Cystic Artery is responsible for the blood supply to the pancreas.
The Cystic Artery is responsible for the blood supply to the pancreas.
Cholecystectomy refers to the surgical removal of the liver.
Cholecystectomy refers to the surgical removal of the liver.
The Islets of Langerhan secrete glucagon and insulin to metabolize carbohydrates.
The Islets of Langerhan secrete glucagon and insulin to metabolize carbohydrates.
The celiac axis and SMA provide blood supply exclusively to the tail of the pancreas.
The celiac axis and SMA provide blood supply exclusively to the tail of the pancreas.
The pylorus preserving pancreaticoduodenectomy removes the pyloric sphincter.
The pylorus preserving pancreaticoduodenectomy removes the pyloric sphincter.
A major complication of pancreatic cancer is the early obstruction of the bile duct leading to jaundice.
A major complication of pancreatic cancer is the early obstruction of the bile duct leading to jaundice.
A laparoscopic Whipple resection removes the entire pancreas along with the duodenum.
A laparoscopic Whipple resection removes the entire pancreas along with the duodenum.
The blood in the spleen drains into the splenic artery, thus increasing its size.
The blood in the spleen drains into the splenic artery, thus increasing its size.
The liver contains four lobes, with two on the anterior surface and two on the posterior surface.
The liver contains four lobes, with two on the anterior surface and two on the posterior surface.
Kupffer cells found in hepatic sinusoids are responsible for protecting the liver from infection.
Kupffer cells found in hepatic sinusoids are responsible for protecting the liver from infection.
The falciform ligament remains from the umbilical vein and aids in liver structure.
The falciform ligament remains from the umbilical vein and aids in liver structure.
Venous blood from the liver returns to the heart exclusively through the hepatic artery.
Venous blood from the liver returns to the heart exclusively through the hepatic artery.
The average storage capacity of the gallbladder is between 60 to 80 mL.
The average storage capacity of the gallbladder is between 60 to 80 mL.
Cholecystectomy is performed due to chronic inflammation or cholelithiasis.
Cholecystectomy is performed due to chronic inflammation or cholelithiasis.
The ERCP procedure involves inserting a scope into the esophagus.
The ERCP procedure involves inserting a scope into the esophagus.
The blood supply to the gallbladder comes from the gallbladder artery.
The blood supply to the gallbladder comes from the gallbladder artery.
90% of cholecystectomies are performed using the open method.
90% of cholecystectomies are performed using the open method.
A choledocholithotomy involves creating an incision in the cystic duct.
A choledocholithotomy involves creating an incision in the cystic duct.
During a cholangiogram, a catheter is inserted into the bile duct to inject contrast dye.
During a cholangiogram, a catheter is inserted into the bile duct to inject contrast dye.
The position for gallbladder surgery is typically the sitting position.
The position for gallbladder surgery is typically the sitting position.
Forced-Air warming blankets are typically used during a liver transplant procedure.
Forced-Air warming blankets are typically used during a liver transplant procedure.
Once blood flow is restored in the new liver, anastomosis of the bile duct is unnecessary.
Once blood flow is restored in the new liver, anastomosis of the bile duct is unnecessary.
The University of Wisconsin Solution is a potassium-based solution used for liver preservation.
The University of Wisconsin Solution is a potassium-based solution used for liver preservation.
Living Related donors are the only type of donors in liver transplant procedures.
Living Related donors are the only type of donors in liver transplant procedures.
The Roux-en-Y technique is applied during liver perfusion to ensure adequate flow.
The Roux-en-Y technique is applied during liver perfusion to ensure adequate flow.
Sutures of size 6-0 Prolene are commonly used for liver anastomosis.
Sutures of size 6-0 Prolene are commonly used for liver anastomosis.
Aseptic technique is not a critical aspect during organ donation procedures.
Aseptic technique is not a critical aspect during organ donation procedures.
Cirrhosis can be caused by alcoholism and is a condition that may warrant liver transplantation.
Cirrhosis can be caused by alcoholism and is a condition that may warrant liver transplantation.
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Study Notes
Biliary Surgery Overview
- Biliary surgeries involve the gallbladder, pancreas, spleen, and liver.
- Key surgical types include cholecystectomy, splenectomy, hepatic resection, and transplants.
Biliary Anatomy
- Triangle of Calot is a key surgical landmark for gallbladder removal.
- Blood supply to the gallbladder comes from the cystic artery, arising from the hepatic artery.
- Sphincter of Oddi guards the common bile duct and pancreatic duct, regulating bile flow.
Significant Arterial Supply
- Celiac Axis arises from the abdominal aorta, providing blood to the stomach, spleen, and liver via its three main branches.
Gallbladder Function
- Located posterior to the liver, stores and concentrates bile for digestion.
- Average bile storage capacity is 40-70 mL, with release occurring in the duodenum.
Perioperative Considerations
- General anesthesia is used for biliary surgeries, which can be performed open or laparoscopically.
- Blood loss prevention is critical; scrub nurses play an essential role.
- Surgical counts are significant with major counts at initial and closing stages.
Surgical Interventions
- Cholecystectomy: removal of the gallbladder, primarily laparoscopic.
- ERCP (Endoscopic Retrograde Cholangiopancreatography): used for diagnosing biliary tract issues, may identify blockages.
Cholecystectomy Steps
- Involves incising the Triangle of Calot, ligating and dividing the cystic artery and duct, and dissecting the gallbladder from the liver bed.
Pancreas Anatomy and Function
- Located behind the stomach, approximately 25 cm long, functioning in both exocrine (enzyme secretion) and endocrine (hormone production) capacities.
Pancreatic Cancer
- Predominantly arises from the head of the pancreas, with 80% being ductal adenocarcinoma.
- Often leads to jaundice due to bile duct obstruction.
Laparoscopic Whipple Resection
- Involves removing the head of the pancreas, duodenum, part of the jejunum, and lower common bile duct, aimed to restore gastrointestinal continuity and improve patient quality of life.
Liver Anatomy and Function
- Positioned in the right upper quadrant, vital for metabolizing fats, proteins, and carbohydrates.
- Comprised of lobules, each containing a portal triad (hepatic ducts, portal vein branch, hepatic artery branch).
Liver Surgery Considerations
- Hepatic Resection removes tumors, necessitating effective hemostasis.
- Procedures must adhere to strict aseptic techniques.
Liver Transplantation
- Involves donor liver implantation; types include cadaveric and living related donations.
- Major diseases warranting transplantation include primary hepatic cancer, cirrhosis, and biliary atresia in children.
Organ Donation Process
- Governed by the Trillium Gift of Life Network in Ontario, ensuring coordination of organ and tissue donations.
- Types of donors include Neurological Determination of Death and After Circulatory Death.
- Aseptic technique is critical throughout the donation and transplantation procedures.
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