Gall bladder cancer

Q) True about the presentation of Gall Bladder cancer is ?

a) 50% of the cancers originate in the fundus and body.

b) Nodal disease is present in 1/3 at presentation.

c) Distant metastasis is present is <1/3 of patients at presentation.

d) Acute cholecystitis due to neck mass has worse prognosis.

AIIMS 2017 Questions

Gall bladder MCQS  

Aclaculus choelcystitis

Q)  True about acalculous cholecystitis is:

a) Mortality more than that of calculus cholecystitis

b) GB rupture chances are more

c) Immediate cholecystectomy is the treatment of choice

d) Only A & B are correct

 A12) d

The disease  process  is  generally  more  fulminant  than  that  of  calculous cholecystitis  and  may  progress  to  gangrene  and  perforation  of  the gallbladder.

Treatment  of  acalculous  cholecystitis  is  similar  to  that  of  calculous  cholecystitis,  with  cholecystectomy  being  therapeutic. Given  the  substantial  inflammation  and  high  risk  of  gallbladder gangrene,  an  open  procedure  is  generally  preferred.

However, many  of  these  patients  are  critically  ill  and  would  not  tolerate  the physiologic  insult  of  a  laparotomy,  explaining  why  the  mortality rate  of  cholecystectomy  for  acalculous  cholecystitis  is  up  to  40%. Accordingly,  percutaneous  drainage  of  the  distended  and  inflamed gallbladder  is  carried  out  in  patients  unable  to  tolerate  a  laparotomy.

Approximately  90% of  patients  will  improve  with  percutaneous  drainage,  and  the  tube  can  eventually  be  removed.  If  follow-up  imaging  continues to  demonstrate  no  stones,  interval  cholecystectomy  is  generally unnecessary.


Perforation during Lap cholecytectomy

Q.     Regarding Lap Cholecystectomy false  is  (AIIMS) 

a.       GB perforation occurs in 40%

b.      Perforation occurs at time of dissection from GB bed

c.       10 – 30 % incidence of missed stones in peritoneal cavity

d.      Missed stones seldom cause any problem in the future

Carcinoma GB epidemiology

Q) Not true about GB malignancy

A. 80 percent of porcelain gall bladder predispose to malignancy

B. Untreated advanced  CA GB  median survival is 2-5 months

C. Stippled calcification of mucosa has higher risk of malignancy than diffuse intramural calcification

D. More than 75 percent of CA gall bladder has history of cholelithiasis


Intra op cholangio

Q) All of the following are indications for performing intra op cholangiography except:

A. Pain around the day of surgery
B. Anomalous biliary anatomy
C. Suspicious findings on ERCP
D. Abnormal hepatic function panel

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Risk factors for Ca gall bladder

Q) Risk factor for CA GB are all except
A. Multiple polyp
B large gall stone >3 cm
D pigment stone same risk as cholesterol stone

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