Bile leak after lap Cholecystectomy

Q) 60 year old female undergoes lap cholecystectomy and is discharged She comes back 8 days later with pain abdomen, distension, fever and tachycardia. USG shows a 500 ml collection in Morrisons Pouch. Next step?

a) Conservative, I V antibiotics

b) USG guided drainage

c) LAP exploration and ligation of cystic duct stump

d) CECT followed by open exploration

#NEET SS 22

# Questions on BIliary system

# Free Questions on Bile ducts

EHPVO with Portal Hypertension

Q) An young male with cholangitis, EHPVO + Portal Biliopathy was drained with a plastic biliary stent next step?

a) Repeat biliary Stenting every 3 months then followed up

b) Replace plastic to bare metal stent

c) Prepare for Lineorenal shunt surgery

d) Do MRCP and proceed accordingly


Points  about Portal Biliopathy

Portal biliopathy (PB) is a clinical condition defined as the presence of abnormalities in the biliary tree (including biliary tree and gallbladder) in patients with non-cirrhotic/non-neoplastic extrahepatic portal vein obstruction (EHPVO) and portal cavernoma.

The spectrum of biliary abnormalities include both  intra- and extra-hepatic biliary stenosis (single or multiple)

With or without consensual above dilation

Bile duct wall irregularity or thickening

Bile duct angulation

Varicose veins located at the ductular walls and gallbladder

 

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