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Hepatopancreatobiliary

Hepatopancreatobiliary. Tom Drake and Fran Young. The Bilirubin Cycle. Liver Function Tests. Hepatotoxicity. ALP- Cholestasis ALT-Hepatocyte damage yGT -Cholestasis. Synthetic Liver Function. Albumin PT- Prolonged in almost all liver problems- Cholestasis to do with Vit K INR

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Hepatopancreatobiliary

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  1. Hepatopancreatobiliary Tom Drake and Fran Young

  2. The Bilirubin Cycle

  3. Liver Function Tests

  4. Hepatotoxicity • ALP- Cholestasis • ALT-Hepatocyte damage • yGT-Cholestasis

  5. Synthetic Liver Function • Albumin • PT- Prolonged in almost all liver problems- Cholestasis to do with Vit K • INR • Protein/Globulin

  6. Clinical Examination

  7. Clinical Examination • Gynaecomastia • Spider Naevi • Palmar erythema • Caput medusae • Bleeding • Jaundice • Bruising • Encephalopathy • Murmurs (Cruveilhier-Baumgarten)

  8. Ascites

  9. Jaundice

  10. Pre-Hepatic Causes • Haemolysis • Genetic • Symptoms?

  11. Hepatic Causes • Hepatitis • Drug Toxicity • Liver disease (Cirrhosis, NAFLD) • Infections • Symptoms?

  12. Post-Hepatic Causes • Any obstruction of the biliary tree • Causes • Symptoms?

  13. Liver • Hepatitis • Cirrhosis • Malignancy

  14. Hepatitis • Viral • Autoimmune • Drug-induced • NAFLD • Ischaemic

  15. Viral Hepatitis • A, B, C, D, E • B and D • High-risk group • Investigation

  16. Viral Hepatitis • A, B, C, D, E • B and D • High-risk groups • Investigation

  17. Viral Hepatitis • Acute phaseNausea, vomiting, appetite, jaundiceHep C • Chronic phase • Outcomes-50% of Hepatocellular Carcinoma-Liver failure

  18. Alcoholic Hepatitis and NAFLD

  19. Cirrhosis • Replacement of liver tissue by fibrosis and regenerative nodules • End stage liver disease • Irreversible loss of liver function • Decompensated Cirrhosis

  20. Biliary Tree • Cholecystitis • Ascending Cholangitis • Primary Biliary Sclerosis

  21. Acute Pancreatitis • Causes • Investigation • Glasgow and VAPOR • Treatment-Fluids-Pain Relief-?Antibiotics

  22. Acute Pancreatitis • Causes • Investigation • Glasgow and VAPOR • Treatment-Fluids-Pain Relief-?Antibiotics

  23. Acute Pancreatitis

  24. Acute Pancreatitis

  25. Chronic Pancreatitis • Causes • Investigation • Treatment • Pancreatic insufficiency

  26. Cholecystitis

  27. Cholecystitis • Symptoms • Causes • Examination • Investigation

  28. Choledocholithiasis /Cholecystitis • What is says on the tin. • ERCP/MRCP • “Hot” Lap-chole • Fluids and antibiotics

  29. Ascending Cholangitis • Causes • Symptoms- Charcot’s Triad • Investigation • Treatment

  30. Pancreatic Cancer • Bad. • Risk Factors • Causes • Types

  31. Pancreatic Cancer • Symptoms • Signs • Investigation • Treatment • Prognosis

  32. Questions

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