Gall bladder

Q   Post cholecystectomy Injury, which is true?

a.       Bile duct leak in approx 1%

b.      Open cholecystectomy bile duct injury 0.5 to 1 %

c.       Most common cause of bile leak is cystic stump blowout and duct of lushka injury

d.      Type E injury is due to clipping of CBD by mistake

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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

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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

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