Biliary Disease

Original chalk talk by Brandon Fainstad, MD.
Graphics, updates and edits by Yilin Zhang, MD. 


OBJECTIVES:

  • Review biliary anatomy
  • Recognize complications of gallstone disease
  • Recognize the utility of diagnostic imaging and therapeutic options for complications of gallstone disease

This talk can be replicated on the board as a chalk talk or the website itself can be used as the teaching platform. Click on each figure for teaching instructions and additional information. Any new text that appears in each figure is displayed in green.


Board set-up and review of biliary anatomy:

Cholelithiasis:

Cholecystitis:

Choledocholithiasis:

Cholangitis:


TAKE HOME POINTS:


REFERENCES:

  1. Bellow, CF, Berger, DH & Crass, RA. Management of Gallstones. 2005. American Academy of Family Physicians. 
  2. Zakko, SF & Afdhal NH. Acute cholecystitis: Pathogenesis, clinical features, and diagnosis. In Grover, S (ed). UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com (Accessed on December, 02, 2017.)
  3. Kiewiet, JJ, et al. A Systematic Review and Meta-Analysis of Diagnostic Performance of Imaging in Acute Cholecystitis. Radiology. 2012, 264(3):708-720.
  4. Arain, MA & Freeman, ML. Choledocholithiasis: Clinical manifestations, diagnosis and management. In Grover, S (ed). UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com (Accessed on December, 02, 2017.)
  5. Afdhal, NM. Acute cholangitis. In Grover, S (ed). UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com (Accessed on December, 02, 2017.)

ADDITIONAL IMAGES:

  • ERCP cholangiogram – http://www.uptodate.com/contents/images/GAST/70088/Obstructing_CBD_stone_ERCP.jpg?title=Obstructing+CBD+stone+ERCP
  • ERCP stone removal and sphinceroteromy – http://www.uptodate.com/contents/images/GAST/67640/Endosc_stone_extraction.jpg?title=Endosc+stone+extraction
  • ERCP cholangitis pre/post – http://www.uptodate.com/contents/images/GAST/62967/Acute_cholangitis_ERCP.jpg?title=Acute+cholangitis+ERCP

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