Ana Phy

Anatomy and
Physiology:
ERCP and
Laparoscopic
Cholecystectomy
This presentation delves into the anatomy and physiology involved in ERCP
and laparoscopic cholecystectomy. These procedures target the biliary
system, specifically the gallbladder, to diagnose and treat various conditions.
by Trixia Cervantes
Biliary System Anatomy
Liver Gallbladder Bile Ducts
The liver produces bile, a digestive fluid The gallbladder stores and concentrates Bile ducts transport bile from the liver to
essential for fat breakdown. bile before releasing it into the small the gallbladder and ultimately to the
intestine. duodenum.
Gallbladder Structure
and Function
1 Pear-Shaped Organ 2 Bile Storage
The gallbladder is a small, It serves as a reservoir for
pear-shaped organ located bile, concentrating it and
beneath the liver. releasing it into the small
intestine when needed for
digestion.
3 Fat Digestion
Bile aids in the digestion and absorption of fats, making it crucial for
maintaining proper lipid metabolism.
Pathophysiology of Gallstone Disease
Gallstone Formation Bile Duct Obstruction Complications

Gallstones form when cholesterol, Gallstones can obstruct the bile duct, Complications include pancreatitis,
bilirubin, and other substances leading to pain, inflammation, and cholangitis, and gallbladder infections.
crystallize in the gallbladder. jaundice.
Diagnostic Imaging Techniques
Ultrasound CT Scan MRI
Ultrasound is a non-invasive imaging A CT scan provides detailed cross- MRI is a highly detailed imaging
technique that uses sound waves to sectional images of the abdomen, technique that can detect gallstones
create images of the gallbladder and revealing the presence of gallstones and other abnormalities in the biliary
surrounding structures. and other abnormalities. system.
Laboratory Assessments
Test Purpose
Liver Function Tests (LFTs) Evaluate liver health and function
Bilirubin Measure levels of bilirubin, a

breakdown product of heme,
which can be elevated in biliary
obstruction
Complete Blood Count (CBC) Assess for inflammation or

infection
Indications for ERCP
Gallstone Obstruction Cholangitis

ERCP is used to remove gallstones ERCP can drain infected bile from
that are obstructing the bile duct. the bile duct, treating cholangitis, a
serious infection.
Pancreatitis Strictures
ERCP can help diagnose and treat ERCP can dilate strictures,
pancreatitis, a condition involving narrowed areas in the bile duct,
the pancreas, caused by gallstones which can cause blockage.
or other factors.
ERCP Procedure Overview
Sedation 1
The patient is sedated to ensure comfort and minimize
discomfort during the procedure.
2 Endoscope Insertion
An endoscope, a long, flexible tube with a camera and
tools, is inserted through the mouth and into the
Bile Duct Access 3 duodenum.
The endoscope reaches the bile duct, allowing
visualization of the gallbladder and potential blockages.
4 Gallstone Removal
Gallstones are removed through a small basket or a
special balloon catheter.
Stent Placement 5
If needed, a stent, a small, expandable tube, can be
placed in the bile duct to keep it open.
Indications for Laparoscopic Cholecystectom
1 Symptomatic Gallstones2 Acute Cholecystitis 3 Chronic Cholecystitis
Laparoscopic cholecystectomy is This procedure is used to treat Laparoscopic cholecystectomy can
the preferred treatment for acute cholecystitis, a condition also be used to treat chronic
symptomatic gallstones, meaning characterized by inflammation of cholecystitis, a condition involving
they cause pain or other issues. the gallbladder. long-term inflammation of the
gallbladder.
Pre-Operative Evaluation and Planning
Medical History Physical Exam Procedure Explanation

A thorough review of the patient's medical A physical exam, including vital signs and The patient must understand the risks,
history, including previous surgeries, an assessment of the abdomen, is crucial benefits, and alternatives associated with
allergies, and medications, is essential. to ensure the patient is healthy enough laparoscopic cholecystectomy.
for surgery.

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Anatomy and

Gallstone Formation Bile Duct Obstruction Complications

Liver Function Tests (LFTs) Evaluate liver health and function

Bilirubin Measure levels of bilirubin, a

Complete Blood Count (CBC) Assess for inflammation or

Gallstone Obstruction Cholangitis

Medical History Physical Exam Procedure Explanation

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