Gall Bladder Q9- Q15

Q1-8


 

Q9) Risk factor for CA GB are all except
A. Multiple polyp
B large gall stone >3 cm
C PSC
D pigment stone same risk as cholesterol stone

 9 A) 

Its single polyp, Large stone more than 3 cm is a definite risk factor

Gall bladder cancer is seven times more common in those who have gall stones

Type of gall stone has no relation with the risk of malignancy

Other risk factors are APBDJ, PSC and choledochal cyst

Ref sabiston page 1512


Q 10) 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

10) c

Indications of intra op cholangiography are 

Pain at the time of operation

Abnormal hepatic functions panel

Anomalous or confusing biliary anatomy

Inability to perform post op ERCP

Dilated CBD

Any suspicion of choledocholithiasis

From Bailey  Box 54-1

 


Q11 ) Partial cholecystectomy all are true except (JIPMER)
a. Cystic duct should be ligated 
b. Anterior  portion of gb removed and post part left intact
c. Impacted stone should be removed
d. Useful mainly in cases with frozen calots and unable to identify structures

 A10) a

If inflammation has obliterated the triangle of Calot, a partial cholecystectomy with removal of any stones may be all that is possible and usually resolves the condition. In the acute setting, the biliary obstruction often resolves after cholecystectomy and resolution of the inflammatory process 

Ref BG 562

Partial cholecystectomy In it superficial part of the fundus and body of the gallbladder is  excised, leaving in place its attachment to the liver. The remaining mucosa is removed by curettage and/or fulgurated with electrocoagulation, and a closed-suction drain is placed near the infundibulum.