Liver and Biliary System Power point

Largest gland in the body

liver

divides liver into the two major lobes, left and right

falciform ligament

two minor lobes evident on visceral surface of the liver

caudate and quadrate

what supplies oxygenated blood from abdominal aorta

hepatic artery

carries blood from digestive system to be filtered by liver

portal vein

carries the blood away from the liver and into the inferior vena cava, which leads to the right atrium, one of the four chambers of the heart

hepatic vein

what is the livers primary function

to produce bile

bile is collected by ducts and carried to gallbladder for _ to the duodenum

storage

what stores and concentrates bile

gallbladder

the biliary system consist of what two things

bile ducts and gallbladder

what is the name of the two main hepatic ducts

right and left hepatic duct

right and left hepatic ducts join to form

common hepatic ductcom

common hepatic duct unites with

cystic duct

cystic duct forms the what

common bile duct

common bile duct joins the what

pancreatic duct

the pancreatic duct and common bile duct empty into the duodenum via the _

hepatopancreatic ampulla (ampulla of vater)

what controls the flow of bile into small intestine

sphincter of oddi

where is the gallbladder found

visceral surface of the right lobe of liver

position of the gallbladder depends on what

body habitus

what hormone activates the evaluated bile

cholecystokinin

neck of the gallbladder consistent with what

cystic duct

what is an IOC

intra-operative cholangiogram

what takes place during the surgical removal of the gallbladder

IOC

who is in charge of the c-arm during the IOC

radiographer

what does an IOC asses

the presence of gallstones or common bile duct stones

what does PTC stand for

percutaneous transhepatic cholangiography

patients with what will have a PTC done

jaundice

list of pre-procedure considerate for a PTC

• liver function test

• CBC

• prothrombin time

• PTT

• INR

• Platelet count

how is the patient prepped for a PTC

supine and right side is surgically prepared and draped

what kind of anesthetic administered for a PTC

local

what needle is inserted for a PTC

special “skinny” Chiba needle

what kind of contrast is injected for a PTC

water soluble

what images are made after the ductal system is filled with contrast for a PTC

spot AP

what is another name for the postoperative T-tube cholangiography

delayed cholangiography

where does is the T-tube left for a postoperative t-tube cholangiography

it is left in the common hepatic and common bile ducts for drainage

when is postop t-tube cholangiography performed

10 days after surgery of the removal of gallbladder

why is the tube clamped day before procedure for post op t-tube cholangiography

it fills tube with bile to prevent air bubbles from enteringwh

what can air bubbles mimic

radiolucent stones

what are three patient prep for a post op t-tube cholangiography

1. preceding meal is withheld

2. cleansing enema 1 hour before procedure if needed

3. preliminary KUB obtained

what is the patient position for a post op t-tube cholangiography

RPO Position with RUQ centered to IR

what does ERCP stand for

endoscopic retrograde cholangiopancreatography

who performs the ERCP exam

general surgeons or gastroenterologists

what is a ERCP used to dx

biliary and pancreatic pathologic condition

where is an ERCP performed at

sometimes interventional radiology or endoscopy with a c-arm

what is the pts throat sprayed with what for an ERCP

local anesthetic

what can be used to the pt with an ERCP beside a local anesthetic

general anesthesia

what is cannulated in an ERCP

hepatopancreatic ampulla

where is contrast injected in an ERCP

common bile duct