Liver Flashcards
(57 cards)
T/F You may need to remove multiple lobes of the liver because you can’t remove one without sacrificing blood flow to another
true
where does 80% of the liver’s blood supply come from
portal VEIN
What is the most common liver biopsy done? when would you use it?
Guillotine technique use if you have diffuse or lesion at the periphery of the lobe
-3-0 absorb braided will cut through the liver well
When would you use a punch biopsy?
lesion that is more central or closer to the hilus
NEEDS to be closer to the surface and you need to get multiple samples
When would you use laparoscopy biopsy?
more common at universities one down fall is that you cant feel the tissue
can do a true cut or guiletine style
What are the two non surgical biopsy techniques
percutaneous tru cut-good sliver or core tissue
fine needle aspirate and cytology- neoplastic lesions may exfoliate this has a POOR diagnostic yield
When may you need to do a complete and partial liver lobectomy?
neoplasia, trauma, abscess, cysts
Complete liver lobectomy should be done on what liver lobes and with what technique?
left lateral and left medial in SMALL dogs and cats
use the guiletine technique go up to the hilus and with one swoop tie off the vessels
What is a TA stapler
thoracoabdominal stapler that fires multiple rows of staples to crush the tissue and blood supply before you release your cut.
can use it for complete or partial lobectomies
Parital liver lobectomy- what is a parenchymal fracture and ligation
cut through the capsule at the lvl of proposed excision
- crush or aspirate parenchyma
- ligate or cauterize the vessels
- ***results in the greatest blood loss
T/F the parenchymal fracture and ligation done for a partial lobectomy results in the greatest blood loss
true
What are overlapping sutures
full thickness series of overlappng guillotine sutures and make sure they overlap so no vessels are left unoccluded
What are the two big complications you are worried about with sx of the liver?
Hemorrhage
accidental ligation or occlusion of portal veins and cystic ducts of the remaining lobes—->necrosis of the lobe
T/F tumors in the liver are most likely primary tumors
false most of them are metastatic
What are the two types of hepatocellular tumors?
Adenomas - tumors in cats benign may show cs if space occupying
Adenocarcinomas- MOST common primary malignant tumor in dogs
what are the three forms of hepatocellular adenocarcinomas
Massive-malignant but good prog because in left lateral and left medial liver lobs
Nodular- poor prog metastasis likely and complete excise hard
Diffuse- poor prog mets in lymphnodes and lungs
What are the cholangiocellular tumors in dogs and cats?
dogs- second most common primary malignancy most will be intrahepatic and mets of 88%
cats MOST common primary hepatobiliary tumor
50% are adenomas (benign
50% carcinoma number one malignant liver tumor in cats poor prog with mets GROUND GLASS
T/F liver and splenic trauma is usually self limiting and does not require sx
TRUE :)
How are you going to treat trauma of the liver
supportive care with fluids and a possible trasfusion
Where would trauma to the liver have to be to need sx?
closer to the hilus use the PRINGLE maneuver
What is a cholecystectomy ?
incising the gall bladder
When do you need to do a cholecystectomy?
Mucocele
necrotizing, chronic, lihiasis, tumor, trauma
Biliary mucoceles what are they
hyperplasia of mucous secreting cells line the gall bladder -more distension can lead to rupture
What is the signalment and clinical signs of biliary mucoceles
dogs around 9 small and med breeds including cockers, min schnauzer
vomit, anorexia, lethargy, PU/PD D+
