Cholecystostomy

Q.    Regarding percutaneous cholecystostomy A/E

a.       Technical success in 90 – 98 % of cases

b.      Indicated in Grade II cholecystitis with significant pericholecystic inflammation & GOO

c.       Indicated in Gr III cholecystitis with significant comorbidity

d.      In Grade III cholecystitis with biliary peritonitis, PCC results in significant improvement

Answer 

Cholelithiasis with Choledocholithiasis

Q.  Patients with gallstones and choledocholithiasis in a centre with endoscopy, interventional radiology and tertiary care 

a.       Single setting lap chole + CBDE better than endoscopy followed by lap chole

b.      In choledocholithiasis endoscopic clearance alone without lap chole can be done without any long term complication

c.       For impacted ampullary stones with CBD dilatation that requires biliary enteric drainage is performed with a preferred open approach

Answer

 

Gall Bladder Cancer in setting of APBDJ

Q) Gall bladder cancer arising in the setting of APBDJ , all are true except

a) It occurs in younger age

b) Prevalent in Asian countries

c) More common in males

d) Less often associated with Gall stones

Answer (free)
c)  It is more common in females

In APBDJ, pancreatic and biliary duct meet more than 15 mm away from the duodenal wall. APBDJ is seen more in asian countries and is associated as a cause of gall bladder cancer.

It is seen in younger age group

Most of the patients are females

Ref article- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2658122/