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.
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question_answer ANECDOTE
Clinician's Scary Jaundice Story
An experienced internist warned that asymptomatic jaundice in older patients often hides aggressive biliary or liver malignancies.
Dr. Jenzer relays this caution to stress rapid evaluation.
volunteer_activism ADVICE
Plan Procedures For Moderate–Severe Disease
For moderate to severe liver dysfunction, coordinate with the managing team and consider hospital-based procedures.
Stage complex cases and plan smaller appointments or inpatient care to manage unpredictable coagulation and physiology.
volunteer_activism ADVICE
Anesthesia Strategies For Sicker Liver Patients
Prefer isoflurane among volatiles and monitor invasively for severe disease; consider regional techniques to limit general anesthesia.
Use central lines/A-lines when necessary and expect unpredictable hemodynamics in end-stage liver patients.
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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