Surgical Practice Dr. alqhatani

🔹Mx Of Cholecystitis
🔸A. Conservative
▪️Conservative Mx Will Resolve The Symptoms in 90% Of Cases

📍1. Nill By Mouth (NPO)
📍2. IV Fluids & Analgesic
📍3. Antibiotics (Cefazolin/Cefuroxime/Ciprofloxacin)

🔸B. Surgery (Cholecystectomy)
📍1. Do Early CholecysteCtomy Within 5-7 Days From Admission & After Symptoms Resolution

📍2. Emergent Choleystectomy ➡️ Due To Severe Presentation Or Complications

📍3. Do Emergent ECRP ➡️ For CBD Stones Removal

📍4. If Empyema Present ➡️ Do Drainage (CholeCystoStomy) Then Later CholecysteCtomy

📍5. Cholecystitis in Pregnancy ➡️ Do Cholecystectomy During 2nd Trimester Only (Not In 1st Or 3rd Trimester)

🔹Indications for Cholecystectomy
1. Cholecystitis (Symptomatic Patients)

2. Complications Develop (Emergency)

3. Typhoid Carrier

4. Cholesterolosis (Cholesterol Polyps)

5. Risk Of Gallbladder Cancer (Porcelain Gallbladder/Adenomatous Gallbladder Polyps)

6. CBD Stones (Choledocholithiasis)

7. Prophylaxis in
▪︎DM/Congenital Hemolytic Anaemia/Bariatric Surgery

▪︎Large Palpable Stones (>2.5-3cm)/Multiple Small Stones

🔹Complications Of Cholecystitis
🔶A. Preoperative
1. Acute & Chronic Cholecystitis

2. Biliary Colic

3. Obstructive Jaundice (CBD Stones Or Mirizzi Syndrome)

4. Acute Pancreatitis

5. Gallbladder Perforation & Peritonitis

6. Acute Cholangitis

7. Empyema Of Gallbladder (Pus Accumulation)

8. MucoCele Of Gallbladder (Fluid Accumulation)

9. Bowel Obstruction (Gallstone Ileus)

🔶B. Postoperative (After CholecysteCtomy)
1. Bile Ducts Injury ➡️ Present As Postoperative Obstructive Jaundice

2. Post-CholecysteCtomy Syndrome ➡️ Postoperative Continuation Of The Symptoms Due To Residual Stones in The Biliary Tree

3. Post-CholecysteCtomy Choledocholithiasis ➡️ Development Of New Stones in Bile Ducts Many Years After Cholecystectomy Which Then Leads To Obstruction Or Cholangitis

4. Bile Leakage & Peritonitis (Clips Dislodgment)

5. Biliary Strictures

6. Visceral Or Vessels Injury & Haemorrhage

7. Abdominal Abscess

#Cholecystitis part2
#Surgery
https://t.me/Surgery_Practice

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179 views彡 Dr_Thaalnoon_ALqahatani ⁞²⁰²³彡, 18:37

Surgical Practice Dr. alqhatani

🔴Gallstones (Cholelithiasis) & Cholysystitis ▪️Gallstones Are Most Common Biliary Pathology (Affect 10-15% Of Population) ▪️Cholecystitis is Acute Or Chronic Inflammation Of Gallbladder (Mostly Due To Presence Of Gallstones) ▪︎Cholysystitis is The 2nd…

❇️ Very important Table
##Gallbladder
https://t.me/Surgery_Practice

176 views彡 Dr_Thaalnoon_ALqahatani ⁞²⁰²³彡, 18:38

Surgical Practice Dr. alqhatani

Photo

❇️ Very important Table
##Gallbladder
https://t.me/Surgery_Practice

238 views彡 Dr_Thaalnoon_ALqahatani ⁞²⁰²³彡, 18:41

Surgical Practice Dr. alqhatani

❇️ Mirizzi Syndrome
#Cholecystitis
https://t.me/Surgery_Practice

1.2K views彡 Dr_Thaalnoon_ALqahatani ⁞²⁰²³彡, 18:42

Surgical Practice Dr. alqhatani

❇️ Very important Table
#Gallbladder
https://t.me/Surgery_Practice

218 views彡 Dr_Thaalnoon_ALqahatani ⁞²⁰²³彡, 18:43

Surgical Practice Dr. alqhatani

A 52-year-old woman presents 48 hours after onset of RUQ pain, fever and positive Murphy’s sign. Ultrasound shows thickened gallbladder wall and pericholecystic fluid. She is stable. Best management?

Anonymous Quiz

62%

A) Conservative treatment then interval cholecystectomy after 6 weeks

33%

B) Early laparoscopic cholecystectomy during same admission

C) Immediate ERCP

D) Percutaneous cholecystostomy only

❤1

21 voters202 views彡 Dr_Thaalnoon_ALqahatani ⁞²⁰²³彡, 10:33

Surgical Practice Dr. alqhatani

Which factor MOST increases technical difficulty during laparoscopic cholecystectomy?

Anonymous Quiz

A) Female gender

B) Age <50 years

36%

C) Gallbladder wall thickness >5 mm

56%

D) All of the above

25 voters200 views彡 Dr_Thaalnoon_ALqahatani ⁞²⁰²³彡, 10:36

Surgical Practice Dr. alqhatani

A patient with obstructive jaundice, imaging shows a stone impacted in Hartmann’s pouch compressing the CBD. Diagnosis and best treatment?

Anonymous Quiz

18%

A) Choledocholithiasis — ERCP with stone extraction

65%

B) Mirizzi syndrome — Cholecystectomy ± endoscopic relief of obstruction

15%

C) Ascending cholangitis — ERCP with sphincterotomy and drainage ± stone extraction

D) Benign biliary stricture — Endoscopic dilatation

79 voters1.34K views彡 Dr_Thaalnoon_ALqahatani ⁞²⁰²³彡, 10:42

Surgical Practice Dr. alqhatani

A 68-year-old diabetic man presents with RUQ pain, fever, positive Murphy’s sign, and leukocytosis. CT shows gas within the gallbladder wall. What is the most likely diagnosis?

Anonymous Quiz

A) Uncomplicated acute calculous cholecystitis

B) Acalculous cholecystitis

C) Biliary colic

86%

D) Emphysematous cholecystitis

21 voters198 views彡 Dr_Thaalnoon_ALqahatani ⁞²⁰²³彡, 10:47

Surgical Practice Dr. alqhatani

Which condition predisposes specifically to pigment stone formation?

Anonymous Quiz

12%

A) Obesity