Dr. Andrew Jenzer, an oral maxillofacial surgeon from North Carolina, discusses the crucial link between liver disorders and oral surgery. He explains liver functions and bile flow, as well as the implications of liver function tests. Jenzer highlights the dangers of liver damage, including conditions like cirrhosis and hepatic encephalopathy, and emphasizes the need for careful management of patients with liver dysfunction. The talk also touches on the challenges of anesthesia and medication considerations for these patients, ensuring optimal care during surgical procedures.
57:09
forum Ask episode
web_stories AI Snips
view_agenda Chapters
auto_awesome Transcript
info_circle Episode notes
insights INSIGHT
Liver's Core Multitasking Role
The liver stores glycogen, performs gluconeogenesis, detoxifies, produces bile, and makes most plasma proteins including coagulation factors.
Remember vitamin K–dependent factors (II, VII, IX, X) and that factor VIII and von Willebrand come from endothelium, not hepatocytes.
insights INSIGHT
Bilirubin Pathway And Clinical Signs
Senescent RBCs break down to heme → biliverdin → unconjugated bilirubin which travels bound to albumin to the liver.
Conjugation in liver enables biliary excretion and gives urine and stool their normal colors; buildup causes jaundice and pruritus.
volunteer_activism ADVICE
Urgent Workup For Asymptomatic Jaundice
In older asymptomatic patients, act quickly on new jaundice because it can signal biliary or hepatic malignancy.
Order a full workup promptly rather than assuming benign causes.
Get the Snipd Podcast app to discover more snips from this episode
Liver disorders affect oral surgery greatly, and in this episode of Everyday Oral Surgery, Dr. Andrew Jenzer joins us to do a medicine review of liver disorders. Tuning in, you’ll hear all about the function of the liver, how bile flows through the body, liver function tests, the different kinds of liver damage, and how the gallbladder affects the liver. We also discuss a couple of interesting liver disorders before Andrew tells us how patients with liver dysfunction are evaluated and managed by oral surgeons. Finally, our guest does a review of medication used to treat liver dysfunction patients and their side effects and even reminds us to be conservative with medication for patients with moderate to severe liver damage. To hear all this and so much more, press play now!
Key Points From This Episode:
Welcoming today’s guest, Dr. Andrew Jenzer.
The functions of the liver, what bile is, and how it flows through the body.
The dangers of asymptomatic jaundice.
What increases unconjugated and conjugated bilirubin levels.
Liver function tests, what they include, and what they indicate.
The different types of liver damage that can occur and elevations indicating liver injury.
How gallbladder blockages affect the liver and bile movements.
Cirrhosis, the categories of it, and what happens when it occurs.
Andrew tells us about the interesting disorder, hepatic encephalopathy, and how it’s treated.
How patients with liver dysfunction are evaluated and managed by oral health professionals.
A review of medication that can be used for liver dysfunction patients and their side effects.
The importance of being conservative with medicine for moderate to severe liver dysfunction.
Everyday Oral Surgery