Liver Biopsy Procedure Steps

What is the purpose of intraoperative cholangiography?

To assess the liver function
To examine the pancreatic duct
To avoid the need for surgical exploration of the common bile duct (correct)
To visualize the gallbladder

What contrast media is recommended for intraoperative cholangiography?

No contrast media is used
High iodine content with 20mL volume
High osmolar contrast media (HOCM) (correct)
Low iodine content with 30mL volume

How can spasm of the sphincter of Oddi be relieved during intraoperative cholangiography?

By switching to a different imaging technique
With glucagon, propantheline, or amyl nitrite (correct)
With excessive contrast medium injection
By increasing the iodine content of the contrast medium

What are the criteria for a normal operative choledochogram according to Le Quesne?

Terminal narrow segment of the duct not clearly visible (D) Signup and view all the answers

When is postoperative (T-Tube) cholangiography indicated?

Postoperatively following certain surgeries (D) Signup and view all the answers

What is the recommended action if a duct is not entered at the first attempt during a liver intervention?

Withdraw the needle to approximately 2–3 cm from the liver capsule and redirect it towards different positions (C) Signup and view all the answers

What is the main reason to avoid excessive parenchymal injection during a liver intervention?

Leads to opacification of intrahepatic lymphatics (A) Signup and view all the answers

When should the needle be removed during a diagnostic percutaneous transhepatic cholangiography (PTC) procedure?

After obtaining suitable diagnostic images (A) Signup and view all the answers

What should be done to avoid overfilling an obstructed duct system during a liver drainage procedure?

Take care not to overfill and precipitate septic shock (B) Signup and view all the answers

What imaging sequence should be followed when using the undercouch tube for a patient during a liver intervention?

PA, LAO, RAO (A) Signup and view all the answers

What is the size of the Chiba needle used for puncturing the duct in the right lobe of the liver during a transhepatic procedure?

22G (B) Signup and view all the answers

What is the purpose of a sheath that can be inserted during a percutaneous transhepatic cholangiogram?

To guide a catheter access into the bile ducts (B) Signup and view all the answers

When might balloon dilatation be required in endoscopic procedures?

After stent deployment (C) Signup and view all the answers

What is the recommended interval for exchanging an externally draining catheter according to the text?

3-monthly (C) Signup and view all the answers

What complication can occur above the stricture during the passage of a guidewire in percutaneous procedures?

Perforation of bile duct (B) Signup and view all the answers

What is the purpose of using contrast medium during percutaneous transhepatic cholangiography?

To visualize the biliary system during the procedure (B) Signup and view all the answers

What is a contraindication for percutaneous transhepatic cholangiography?

Prothrombin time prolonged >2 s more than control (C) Signup and view all the answers

What patient preparation is recommended before percutaneous transhepatic cholangiography?

Nil by mouth or clear fluids only for 4 hours prior to the procedure (B) Signup and view all the answers

What complications can arise due to the technique of injecting contrast medium during percutaneous transhepatic cholangiography?

Septicaemia with high injection pressures (D) Signup and view all the answers

Why are antibiotics considered before percutaneous transhepatic cholangiography?

To control infection if there is biliary tract sepsis (C) Signup and view all the answers