Biliary System

Questions on Biliary system from exams.

Answers are provided after a set of 5 questions. 

  Questions 1-6              Questions 12-17                   Questions 18-20


Q7. Most common site for cholangiocarcinoma is


  1. a) Intrahepatic bile ducts
  2. b) Hepatic duct bifurcation
  3. c) Middle  CBD (Common Bile Duct)
  4. d) Lower 1/3rd of CBD (Commmon Bile duct)

Q8. Which is the least common anatomic variation of extrahepatic biliary system?

  1. a) Trifurcation of Right anterior, right posterior and left hepatic ducts.
  2. b) Right anterior hepatic duct joining the common hepatic duct
  3. c) Right Posterior hepatic duct joining the common hepatic duct
  4. d) Anomalies of the gall bladder

Q9. Which of the following is not true for Acalculus cholecystitis?

  1. a) It accounts for 5-10% cases of Acute Cholecystitis.
  2. b) This entity has a more fulminant course than calculus cholecystitis
  3. c) Acalculus Cholecystitis is commonly seen after burns, trauma or major cardiac surgeries.
  4. d) Cholescintigraphy is the investigation of choice for detecting Acute Acalculus Cholecystitis.

Q10. How much bile is produced by liver /day?

  1. a)  100-300 ml
  2. b)   300-500 ml
  3. c)   500-1000ml
  4. d)   500-1200 ml


Q11. Which of the following is not a criteria for diagnosing Sphincter of Oddi Dysfunction

Sphincter of ODII
Sphincter of Oddi dysfunction
  1. a) Common Bile Duct  diameter more than 12 mm on USG
  2. b) Decrease in Common Bile Duct  pressure after infusion of Cholecystokinin
  3. c) Ampullary pressure more than 40 mm Hg
  4. d) Delayed emptying of contrast from Common Bile Duct after ERCP



7.b Hepatic duct confluence

60-80% of cholangiocarcinoma  are located at the Hepatic Duct bifurcation.( Sabiston 18th edition page 1584). In earlier reviews (Maingot' 10th edition page 1841) , the most common site mentioned is Common bile Duct (33-40%)  followed by  Common Hepatic duct (30-32%) and Hepatic duct bifurcation (20%).
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