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Chapter 10 ♦ Liver, Gallbladder, and Biliary Tree Disorders

V. Endoscopic Retrograde Cholangiopancreatography: A. Combines endoscopic and fluoroscopic techniques. B. Typically performed for biopsy, stenting (e.g., common bile duct and pancreatic duct obstruction), stone extraction, papillotomy, and sphincterotomy. Quick Cuts • The right and left lobes are separated by the interlobar fissure, NOT the falciform ligament. • A replaced right hepatic artery comes from the SMA instead of the common hepatic. HEMANGIOMA (FIG 10-3) I. Etiology: Most common benign hepatic tumor. II. Clinical presentation: A. Usually asymptomatic, discovered incidentally. B. Females > males. III. Diagnosis: A. Based on imaging. B. Centripetal enhancement is pathognomonic. IV. Treatment: Resect if symptomatic—causing pain or thrombocytopenia. V. Prognosis: Excellent. Usually does not require intervention.

Figure 10-3: MRI of hemangioma ( arrows ). (From Smith WL. Radiology 101 , 4th ed. Baltimore: Lippincott Williams & Wilkins; 2013, courtesy of Alan Stolpen, MD.)