Overview Cholecystectomy is one of the most frequently performed general surgery procedures in the United States (US) with over 500,000 being performed annually. There are many reasons for this, including the frequency of gallbladder disease and indications for intervention in…
Overview The first reports of an operative cholecystostomy are attributable to Johannes Fabricius (1618) and Stalpert Von Der Wiel (1667) who described the procedure as occurring almost by happenstance upon the incision of an abdominal wall abcess. The following two…
Overview Cholecystitis, a common condition usually resulting from complications of cholelithiasis, occurs in two forms: acute and chronic. Acute cholecystitis requires urgent intervention, typically with antibiotics and cholecystectomy. In the setting of acute cholecystitis, cholecystectomy is optimally performed within 72…
Introduction The aim of this chapter is to describe established and novel findings on the natural history of gallstones. Gallstones have been a scourge of humankind for millennia. Each year surgeons perform over 700,000 cholecystectomies in the United States alone,…
Overview Minimally invasive techniques to manage biliary pathology have reduced the need for open operative intervention. Although open exploration for biliary disease has become less common, specific situations like obstructive common duct stones not amenable to endoscopic therapy or restoration…
Radiologic hepatobiliary interventions Minimally invasive hepatic intervention is indicated in a wide range of pathologic conditions and can be generally divided into vascular, biliary, and hepatic parenchymal procedures. The objective of this chapter is to provide a broad overview of…
Equipment needed for standard endoscopic retrograde cholangiopancreatography cannulation Before attempting cannulation of the biliary tree for standard endoscopic retrograde cholangiopancreatography (ERCP), the appropriate equipment must be assembled (see Chapter 20 ). At baseline that equipment should include : Side-viewing duodenoscope…
The concepts of health and quality of life Promotion of health and restoration of quality of life is central to the delivery of healthcare. There is limited value in engaging in a medical intervention if there is no anticipated impact…
Imaging and image-guided therapy of complications after pancreatectomy Imaging after pancreatectomy Computed tomography (CT) is the most common imaging modality for evaluation of the pancreas after surgery. Complications that can be detected on CT include anastomotic leak, abscess, fistula, and…
Introduction In the 1990s, initial reports of fast-track surgical principles detailed their application to cardiac surgery patients with the goal of reducing intensive care unit (ICU) stay. Afterward, a novel multimodal approach to perioperative care was described by Kehlet and…