Gallstones and their related complications have a prevalence ranging from 7% to 10% in developed countries to more than 70% among high-risk groups such as Pima Indians. Direct and indirect costs related to gallstones in the United States in 2004…
Chronic pancreatitis, cystic neoplasms, and suspected or established malignancy are the main indications for pancreatic surgery. The various types of pancreatic surgery are outlined in Box 45.1 . This chapter focuses on types of pancreatic surgery, their associated adverse events,…
Iatrogenic bile duct injury (BDI) continues to be an important clinical problem after biliary surgery, resulting in serious morbidity and occasional mortality. The management, operative risk, and outcome of BDIs vary considerably and are highly dependent on the type of…
Benign biliary strictures (BBS) are most commonly caused by iatrogenic surgical injury, usually after cholecystectomy, or may occur at the site of biliary anastomosis after hepatic resection or liver transplantation (LT). Other causes of BBS include primary sclerosing cholangitis (PSC),…
Gastric outlet obstruction (GOO) and biliary obstruction (BO) occur commonly in patients with primary or metastatic periampullary malignancies. In pancreatic cancer, for example, GOO occurs in up to 10% to 25% of patients, whereas 70% of the patients present with…
Biliary obstruction results from diverse benign and malignant processes, and patients can present with acute or chronic signs and symptoms that vary greatly in severity ( Table 41.1 ). The nature of an obstruction is often immediately clear at the…
Malignant biliary obstruction of the hilum and proximal intrahepatic bile ducts can result from primary pancreaticobiliary cancers, primary liver cancers, portal lymphadenopathy, or metastatic disease. Primary pancreaticobiliary cancers affecting the proximal bile ducts and hilum include cholangiocarcinoma (CCA) and gallbladder…
Malignant strictures of the pancreaticobiliary tree are often difficult to diagnose and treat. Therefore the majority present in more advanced stages of disease, contributing to poor prognosis and outcome. Jaundice is the most common presenting sign and symptom of malignant…
Malignant tumors of the ampulla of Vater are uncommon. Fewer than 1 in 50,000 people older than 40 years are diagnosed with ampullary malignancy each year. Much more common is a heterogeneous group of malignancies occurring in the peri ampullary…
Background and Definitions The pancreas arises in utero from the fusion of the ventral and dorsal pancreatic buds. The dorsal pancreatic bud gives rise to the pancreatic body and tail, and the ventral pancreatic bud gives rise to the pancreatic…