HEPATIC SURGERY EXAM 2023 A+ GRADE

HEPATIC SURGERY EXAM 2023 A+ GRADE left hepatic division - ANS-left medial lobe, left lateral lobes central hepatic division - ANS-quadrate, right medial lobes and gall bladder right hepatic division - ANS-right lateral and caudate lobe contains vena cava and portal vein hepatic trauma management - ANS-fluid therapy, compare peritoneal to systemic PCV, monitor peripheral PCV if maintaining or increase responding to medical management if not consider surgery hemoabdomen - ANS-peritoneal PCV/= peripheral PCV hepatic trauma surgery - ANS-ligate severed vessels, partial hepatectomy, pringle maneuver Closer to hilus greater likelihood of surgery pringle maneuver - ANS-· controls bleeding intraoperative to perform surgery on liver -Occlude inflow of blood to liver at epiploic foramen portal vein and caudal vena cava and compress the region no more than 15 min hepatic biopsy - ANS-- Fine needle aspirate - Tru-cut needle: US guided 14G-16G, or exploratory deploy needle - Laparoscopic: cup forceps or tru-cut or pre-formed loops · Skin biopsy punch: hold compression to stop bleeding or use surgical · Guillotine technique: ligate and crush into liver cut distal to suture peripheral partial lobectomy - ANS-Indications: biopsy, neoplasia, trauma, abscess, cysts parenchymal fracture and ligation - ANS-results in most blood loss (avoid) overlapping sutures - ANS-overlap throws pass needle through parenchyma cut distal thoracoabdominal stapler - ANS-overlapping staples cut along stapling place suture if bleeding · Can do total lobectomy with stapling surgities - ANS-preformed loop plastic applicator use two to prevent bleeding cholecystomoy - ANS-incision into gallbladder cholecystectomy - ANS-removal of the gallbladder - Duodentomy with catheterization of bile duct to check patency, immobilize gallbladder out of fossa, ligate cystic duct and remove gallbladder choledochomtomy - ANS-incision into the common bile duct cholecystoduodenostomy - ANS-surgical anastomosis of gall bladder to duodenum -mobilize gallbladder bring over to duodenum incise and anastomosis (2.4-3cm stoma) to prevent blockage CONTINUES...