Bile duct

GB polyp

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Q)  Not an indication of cholecystectomy in gall bladder polyp?

a) Size more than 1 cm

b) Associated gall stones

c) Age more than 50 years

d) More than 3 in number

Ans d) No relation with number

The only polypoid lesions that have malignant potential and are associated with a significant rate of harboring
malignancy are adenomatous polyps

The most consistent predictors are single polyps, size greater than 1 cm, and age older than 50

BG 796

Timing of cholecystectomy in biliary pancreatitis

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Q) What is true regarding timing of cholecystectomy in biliary pancreatitis ?

a) Cholecystectomy should be done before discharge in severe pancreatitis to prevent recurrent attacks

b) Cholecystectomy should be done in same admission as pancreatitis when severe disease is excluded

c) Early cholecystectomy has been shown to have more complications than interval cholecystectomy

d) Early cholecystectomy increases technical complications

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Questions on Bile ducts?

 Ans b

"Poncho trial " answers this question of timing of cholecystectomy in biliary pancreatitis 

Early cholecystectomy (just before discharge, when the patient has recovered and severe disease excluded), compared to interval cholecystectomy, effectively reduces---

  1. The rate of recurrent gallstone-related complications in patients with mild biliary pancreatitis,
  2. low added risk of complications.

Evidence on the timing of cholecystectomy in severe pancreatitis is scarce. Cholecystectomy is recommended after all signs of pancreatic necrosis have been resolved or if they persist more than 6 weeks

  • Cholecystectomy during the same admission is recommended for patients with mild biliary pancreatitis to prevent recurrent attacks.
  • In cases of severe pancreatitis, surgery is generally delayed until the inflammation subsides.
  • Studies have shown that early cholecystectomy during the same admission for mild to moderate biliary pancreatitis does not increase complications compared to delayed or interval cholecystectomy.

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Management of biliary strictures

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Q) Which of the following is false about management of benign biliary stricture?

a) After HJ,success rate of 80-90% for benign biliary stricture is achieved

b) Recurrent stricture in 5 years is 30%

c) MOst important factor for recurrent stricture is the initial level of injury

d) Liver failure after stricture repair is around 20% 

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