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2. Stone extraction via the T-tube 89 3. Endoscopic method 89 4. Preparation for stone extraction 90 5. Technique 90 6. Results 91 7. Complications 91 8. Discussion 91 Index of Subjects 99 CHAPTER 1 INTRODUCTION This book was conceived as a descriptive atlas of most reliable indication for common bile duct ex routine biliary surgery i. e. , cholecystectomy and ploration. The cholangioscope allows a visual ex exploration of the common bile duct. For the pro ploration of the biliary tree and permits the re ject the two authors worked together for one week moval of common bile duct calculi and other as biopsy under direct visual con at Ninewells Hospital and Medical School, Dundee procedures such on a series of patients with biliary tract disease trol. Both procedures have been described in detail especially selected for the exercise. With the con with emphasis on the practical aspects of their use. sent of the Tayside Health Board and the patients The era of blind bilary surgery is over and the concerned, all the operations and peri-operative sooner this message is received by all concerned, procedures were filmed by the photographic mem the better the outcome of biliary surgical practice bers of the team, Mr. and Mrs. Paz-Partlow. Ad overall. ditional case material has been obtained from It has not been our intention to produce a com Cedars Sinai Medical Center, Los Angeles.
"For more than half-a-century, Zollinger's Atlas of Surgical Operations has been the gold-standard reference for learning how to perform the most common surgical procedures using safe, well-established techniques. The ninth edition continues this tradition of excellence with the addition of color illustrations and coverage of more than 230 procedures, including many of the most important laparoscopic operations. Following the proven effective design of previous editions, each procedure is fully explained on two pages. The right page contains beautifully rendered line drawings with color highlights that depict every important action a surgeon must consider while performing the operation. The facing page includes consistently formatted coverage of indications, preoperative preparation, anesthesia, position, operative preparation, incision and exposure, procedure, closure, and postoperative care."--Publisher's website.
This book is written as a reference and guidebook for practicing surgeons, gastroenterologists, and interventional radiologists with an interest in hepatobiliary diseases. It presents a strategy to enhance surgeons practice and the care of patients.
Although benign biliary disease is an area in which many surgeons have experience, there are many nuances to providing the highest quality of surgical care. The biliary anatomy is unique but presents with anatomical variances and can be distorted by benign pathology. Biliary surgery has been one of the areas where minimally invasive techniques were first applied in the late 1980s. However, surgical technique has continued to evolve due to acquisition of advanced minimal surgical skills and improvement in surgical technology. The expertise, sage, and knowledge of the members of the Society of American Gastrointestinal and Endoscopic Surgery (SAGES) have prioritized the creation of this manual on modern biliary surgery. This manual will provide the standard for the current state of biliary surgery in the 21st century. The SAGES Manual of Biliary Surgery will align with the new SAGES University Masters program. The Manual supplements the Masters Program Biliary Surgery Pathway. Its goal is to help the surgeon progress from the competent to the proficient and finally to the mastery level. Both for the surgical trainee and senior surgeon, this guidebook will also give insight into modern evaluation and management. The highlights will emphasize what is both feasible and safe from a minimally invasive approach in biliary surgery. The concept of Safe Cholecystectomy will be defined and expounded on in detail. The difficult cholecystectomy will be given ample coverage to include management of intraoperative bile duct injury, indications and techniques of subtotal cholecystectomy, and special attention to intraoperative diagnostic imaging that serve as adjuncts, including cholangiograpy, ultrasound, as well as indocyanine green biliary fluorescence. We will review the updated international Tokyo guidelines for acute cholecystitis. Furthermore, the evolution of treatment of choledocohlithiasis has evolved the most in recent years, and thus requires an extensive discussion of the non-operative and operative management of bile duct stones. This text will serve as an important contribution to the medical literature sponsored by SAGES, an international leading authority in gastrointestinal surgery with a keen interest in safe and proficient biliary surgery. Leaders in the field of biliary surgery will impart their insight and considerable experience in the chapters planned for this manual. The intent for this manual is to be the cited resource for high quality and applicable knowledge for the treatment of benign biliary disease.
This volume addresses the current lack of knowledge of many general surgeons and trainees in the comprehensive management of patients with choledocholithiasis, with an emphasis on how the surgeon can provide single-stage management for the majority of patients. It begins with a historical perspective on surgical techniques for laparoscopic common bile duct exploration (LCBDE) and reviews the knowledge and experience gained during the “open” era. Subsequent chapters cover preoperative evaluation, decision-making, and operative management, including intraoperative cholangiography, intraoperative ultrasound, laparoscopic and open common bile duct exploration, laparoscopic placement of biliary stents and other adjuncts, and laparoscopic bilio-enteric bypass. The volume also provides the reader with material on the full spectrum of options including chapters on endoscopic retrograde cholangiopancreatography and percutaneous approaches to the biliary tree. The chapters on individual procedures emphasize the technical aspects of the procedures, and include rich visual resources to guide the reader (illustrations, photographs, and videos to demonstrate typical cases and also challenging cases), as well as their outcomes and complication management. Finally, there is a discussion of how to identify and overcome logistical and institutional barriers to the adoption of LCBDE, and how simulation may be used to help teach the procedure. Choledocholithiasis: Comprehensive Surgical Management will be of great value and utility to General Surgeons, Hepatobiliary Surgeons, Surgical Residents and Fellows, Endoscopists, and Interventional Radiologists.
This book is part of a series covering surgical specialties. The volumes are multi-authored, containing brief chapters, each of which are devoted to one or two specific questions or decisions within that specialty that are difficult or controversial. The volumes are intended as a current and timely reference source for practicing surgeons, surgeons in training, and educators that describe the recommended ideal approach, rather than customary care, in selected clinical situations.
The first laparoscopic cholecystectomy, performed by Prof. Philippe Mouret in 1987 and described by himself in the first chapter of this book, was an event that revolutionized surgery in the past few decades. Although the majority of surgeons today are unfamiliar with the his- ry of early minimally invasive surgery developments, it is important to realize that the advent of laparoscopy led not only to new surgical te- niques, but also to a change in the doctrine of medical care, by streng- ening the concept of minimal invasiveness. This is particularly the case for biliary lithiasis, for which laparoscopy has provided major benefits in terms of both diagnosis and surgical tre- ment. However, our understanding of the etiology of this disease, as well as the availability of effective medical therapies, have remained subst- tially unchanged over time. The application of the innovative approach has not been, in routine practice, without problems: between 1990 and 2000, the rate of serious complications from laparoscopic cholecystectomy were four times higher than those observed with open surgery. Even initial attempts at lapa- scopic treatment of biliary common bile duct stones resulted in excessive complications and associated medico-legal problems. Nonetheless, today, most indications have been stated, techniques have been standardized, and a new aspect to the treatment of biliary lithiasis has appeared.
Hepatobiliary and Pancreatic Surgery is part of the Master Techniques in Surgery Series, which presents common and advanced procedures in the major subspecialties of general surgery. The series is overseen by Josef E. Fischer, MD, editor of the classic two-volume reference Mastery of Surgery. Hepatobiliary and Pancreatic Surgery depicts surgery of the liver, hepatobiliary tree, and pancreas, including cholecystectomy and hepatic resections. Both laparoscopic and open procedures are depicted. The book is written by acknowledged master surgeons, emphasizes surgical procedures, and is lavishly illustrated with original full-color drawings. Each chapter briefly assesses indications, contraindications, and preoperative planning before fully explaining and illustrating the procedure in step-by-step detail. Outcomes, complications, and follow-up are also discussed. Each chapter ends with a brief reference list. A companion website will offer the fully searchable content of the book and procedural videos.
Extensively revised with new illustrations, new clinical photos, this classic text remains the most comprehensive and up-to-date resource on surgery of the hepatobiliary and pancreatic region. Dr. William Jarnagin and his team of internationally recognized surgeons continue the Blumgart’s tradition of excellence, bringing you the latest advances in diagnostic and surgical techniques. You’ll find updates on the newest minimally invasive surgeries, new interventional diagnostic techniques, and complete coverage of all relevant diseases, including those seen in the tropics. Considers all worldwide opinions and approaches to management, and includes key data on surgical outcomes to better inform your clinical decision-making. Covers exactly what you need to know, balancing basic science with information on clinical practice. Presents cutting edge guidance on pathology, diagnostics, surgery and non-operative intervention of the liver, biliary tract, and pancreas in a single, comprehensive reference. Covers the most recent non-surgical therapies for pancreatic cancer, microwave ablation, and other emerging technologies. Brings you up to date with recent developments in transplantation, minimally invasive surgery, percutaneous devices, pre- and post-care, blood transfusion, and surgical techniques for the spleen. Features an extensively revised art and illustration program, with new anatomical line drawings (including hundreds now in color), more than 750 new clinical photos, more schematic diagrams that summarize information, and new graphs and algorithms throughout.