外科：一般外（liver）

17 flashcards · Other · by Wanying Koh

1. Pringle maneuver: 1) function? 2) which structure? 3) containing what?

   1) during liver surgery for trauma 會夾住的部位 to decrease blood loss 2) hepatoduodenal lig. 3) hepatic a., portal v., CBD

2. caudate lobe of liver = which Couinaud segment?

   segment 1

3. gallbladder is located between right lobe & caudate lobe of liver

4. Liver abscess indications for surgical intervention 1) 2) 3) 4)

   1) large 2) multiple 3) loculation 4) poor drainage 大顆、多顆、分葉、drainage 效果不好

5. Treatment for liver abscess + septic shock

   依然可以 IV antibiotics + percutaneous drainage 治療

6. most common benign liver tumor

   hemangioma (2nd common: focal nodular hyperplasia)

7. hemangioma 是否能 biopsy as diagnosis

   不行, possible rupture (CT, U/S for Dx)

8. FNH 如何與 HCC DD?

   FNH has kupffer cells, use technetium sulfur colloid 染色 （HCC 無）

9. MELD score 1）what does it measure? 2）comprises of what?

   1) severity of liver disease -> indicates which pt should be prioritized for transplant 2) BIC - serum bilirubin, INR, creatinine levels (scores from 6 to 40, which equates to an estimated 3-month survival rate from 90% to 7%, respectively. scores >=17 are considered candidates for liver transplantation. scores <15 are deferred.)

10. Fibrolamellar HCC vs HCC 1) prognosis? 2) M:F ? 3) invasive? 4) age group

    1) better prognosis 2) 1:1 3) less invasive 4) younger age

11. treatment for liver laceration

    90% can receive non-conservative tx (also for splenic trauma) unless +pancreatic trauma -> require surgery

12. complications of liver laceration biliary tract x2 blood x2 liver x1

    jaundice biliary tract damage rebleeding delayed hemorrhage liver abscess

13. Child-Pugh score

    BAPAE bilirubin <2 // 2-3 // >3 albumin >3.5 // 2.8-3.5 // <2.8 PT <4 // 4-6 // >6 ascites encephalopathy

14. gastro-esophageal varices cause tx

    caused by liver cirrhosis tx TIPS Warren shunt liver transplant

15. TIPS transjugular intrahepatic portal shunt fnt

    control liver cirrhosis varices shunt between portal v. <> hepatic v. new pathway to allow bloodflow, reduce obstruction in liver (which worsens portal HTN), improves varices condition

16. Warren shunt

    control liver cirrhosis varices = distal splenorenal shunt splenic v. detached from portal v., connected to L renal v. L. gastric v. detached from portal v. and tied off bloodflow: splenic v. >> L. renal v. >> IVC

17. Cantlie's line

    IVC <> gallbladder fossa parallel to middle hepatic v. splits liver into left and right regions