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Hepatobiliary surgery: gallstones, cholecystitis, obstructive jaundice

General Surgery · MBBS

Study notes

Fever, jaundice, RUQ pain — Charcot's triad; cholangitis; ERCP drains urgently. Cholangitis (CBD stone — Charcot's: fever, jaundice, RUQ pain; Reynolds' adds hypotension/confusion): antibiotics + urgent ERCP drainage — pus under pressure kills. Cholecystitis (gallbladder — fever + Murphy's inspiratory arrest: antibiotics + laparoscopic cholecystectomy early). Obstructive jaundice (dilated ducts — stone: ERCP removes; tumor — periampullary: Courvoisier's — palpable gallbladder + jaundice = malignancy — Whipple). LFTs — obstructive (ALP/GGT high), hepatocellular (ALT/AST high). The triad is the emergency — drain the pus.

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