Questions and Answers
What is the primary landmark for the surgical removal of the gallbladder?
Which artery provides blood supply to the cystic duct?
Which structure is responsible for protecting the common bile duct and the pancreatic duct?
What are the three components referred to as the '3 C's' in biliary surgery?
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What is the significance of the celiac axis in the abdominal cavity?
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What are the two main functions of the pancreas?
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Which of the following describes the primary reason for performing a pylorus preserving pancreaticoduodenectomy?
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Which structure is primarily responsible for the blood supply to the pancreas?
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What is the main complication associated with pancreatic cancer due to tumor location?
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What is the surgical procedure that involves the removal of the head of the pancreas, duodenum, and part of the jejunum?
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What is the average storage capacity of the gallbladder?
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Which artery supplies blood to the gallbladder?
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What is the primary purpose of an Endoscopic Retrograde Cholangeopancreatography (ERCP)?
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Which surgical procedure involves the removal of the gallbladder?
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During a cholecystectomy, what is the most common method used to perform the procedure?
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What does a Cholangiogram test highlight during surgery?
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Which instrument is typically used in laparoscopic surgery to remove stones from the common bile duct?
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What is the initial surgical count type used for both open and laparoscopic procedures?
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What is an essential component of the pancreatic transplant procedure?
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Which type of transplant is most commonly performed for patients with diabetes?
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What is the main function of the spleen?
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What is a critical requirement during a splenectomy procedure?
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In which area of the body is the spleen located?
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For a splenectomy, which method is appropriate for mobilizing the spleen?
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What is a potential indication for performing a splenectomy?
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Which surgical approach involves the use of a trocar during a splenectomy?
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What is the primary purpose of using CUSA, Hydrojet, Argon Beam, and Ligasure during a procedure?
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Which type of liver disease is NOT typically treated with a liver transplant?
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What type of sutures are preferred for permanent vascular anastomosis during liver transplantation?
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What is the approximate liver perfusion time before transplantation?
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What is a major critical step prior to the organ donation process?
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Which situation describes a potential type of donor as per organ donation types?
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What is the primary role of the Trillium Gift of Life Network?
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Which of the following is NOT used as a solution for liver preservation?
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Study Notes
Biliary Anatomy
- Includes the liver, gallbladder, pancreas, spleen, and biliary ductal system.
- Triangle of Calot: crucial landmark for cholecystectomy, consisting of the common hepatic duct, cystic duct, and cystic artery.
- Common hepatic duct: junction of left and right biliary ducts; receives blood from the cystic artery (branch of the hepatic artery).
- Sphincter of Oddi: regulates bile and pancreatic duct flow into the duodenum.
Gallbladder
- Positioned behind the liver, it concentrates and stores bile with a capacity of 40 to 70 mL.
- Bile secretion aids digestion in the duodenum, supplied by the cystic artery.
Perioperative Nursing Considerations
- General anesthetic utilized during surgeries.
- Patients positioned supine for procedures.
- Scrub nurses play a critical role in blood loss prevention, including surgical counts.
Surgical Interventions
- Cholecystectomy: gallbladder removal due to chronic inflammation or cholelithiasis, predominantly performed laparoscopically.
- Other biliary surgeries include endoscopic retrograde cholangiopancreatography (ERCP) for diagnosis and treatment of biliary tract issues.
- Spleen and liver surgeries involve splenectomy and hepatic resection or transplant procedures.
ERCP Procedure
- Endoscopic approach to diagnose biliary tract problems; X-ray and catheter used to visualize the biliary tree.
- Contrast dye highlights blockages, such as stones leading to choledocholithotomy for stone removal.
Pancreas Overview
- Exocrine function involves secretion of pancreatic enzymes; endocrine function involves insulin and glucagon secretion.
- Location: behind the stomach, approximately 25 cm long, supplied by celiac axis and SMA.
Pancreatic Cancer
- Primary tumors arise predominantly from the head of the pancreas (ductal adenocarcinoma).
- Symptoms include bile duct obstruction leading to jaundice; prognosis is often poor due to late diagnosis.
Whipple Resection
- Known as pancreaticoduodenectomy, involves removal of the pancreas head, duodenum, part of jejunum, distal stomach, and lower common bile duct.
- Pylorus-preserving variant aims to improve the patient’s quality of life by preserving the pyloric sphincter.
Pancreatic Transplant
- Multiple options: pancreas transplant alone, simultaneous pancreas-kidney transplant (SPK), or pancreas after kidney transplant (PAK).
- SPK is the most common method, involves anastomosing donor pancreas to the jejunum for drainage.
Spleen Anatomy and Function
- Located in the upper left quadrant, filtering blood and producing white blood cells; also stores blood and platelets.
- Blood supply comes from the splenic artery and vein.
Splenectomy
- Indications include trauma, malignancies, and infections.
- Requires general anesthesia, significant intraoperative counting, and hemostatic management.
Liver Transplantation
- Involves anastomosis of donor liver with recipient’s blood vessels and bile ducts to restore function.
- Solutions used for preservation include University of Wisconsin solution.
Trillium Gift of Life Network
- Ontario agency coordinating organ and tissue donation and transplantation services.
- Emphasizes the significance of maintaining aseptic technique throughout organ donation procedures.
Organ Donation
- Types: neurological determination of death (NDD) and after circulatory death (DCD).
- Consents and legally required signatures are necessary before donation; meticulous procedure planning essential for efficacy and ethics.
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Description
This quiz covers essential topics related to biliary surgery, including anatomy and procedural considerations for surgeries involving the liver, gallbladder, pancreas, and spleen. It also addresses the transplant process in Canada and issues related to death in the operating room. Ideal for RPN perioperative program students seeking to deepen their understanding of biliary surgeries.
