THE GALLBLADDER AND BILE DUCTS

Mohammed Al Sebayel

Surgical anatomy of gallbladder and bile ducts

Biliary Presentations

Surgical operations for malignant jaundice

Preoperative preparation

  • Oral H2 antagonist
  • Vit. K (fat soluble) or FFP
  • Perioperative broad-spectrum antibiotics
  • Rehydration and adequate diuresis
  • Furosemide/ Mannitol
  • Catheterization & CVP monitoring

Carcinoma gallbladder:

  • Radical Cholecystectomy with wedge resection & CBD excision

Cholediocholithiasis:

  • ERCP removal, CBD exploration

Cholangio Ca:

  • Liver resection, Whipple operation,
  • Stenting by ERCP or PTC- palliative

Biliary Stricture:

  • Hepatico-jejenostomy

Periampullary Ca:

  • Whipple’s operation

Carcinoma head pancreas:

  • Whipple op.
  • Bilio-enteric bypass (palliative)