This chapter includes a review of both imaging and percutaneous intervention of the biliary system. A thorough evaluation of a patient with obstructive jaundice includes detailed medical and surgical history, physical examination, laboratory data, and evaluation of pertinent imaging. A…
Cholelithiasis represents a significant problem for the health system in both developed and developing societies, affecting 10% to 15% of the adult population, corresponding to 20 to 25 million Americans who have or will have cholelithiasis. Laparoscopic cholecystectomy is the…
Mortality after pancreatic resection has greatly decreased in comparison with historical series, from 33% following Whipple's initial reports to currently less than 2% in most high-volume centers, resulting in the recognition that assessment of surgical quality for these high-acuity patients…
In 1993 the Diabetes Control and Complications Trial Research Group reported that patients with insulin-dependent diabetes mellitus (IDDM) treated with intensive insulin therapy showed a reduced risk of developing retinopathy, albuminuria or microalbuminuria, and clinical neuropathy, when compared with patients…
There is much about the pediatric pancreas that can be informative to the adult surgical specialist. Problems that are commonly seen in infants and children, such as annular pancreas, may remain occult until adulthood. Pediatric management strategies, such as the…
Pancreatic injuries, despite their relative infrequency, are regarded with great respect among experienced trauma surgeons because of their significant associated mortality and morbidity. Pancreatic injuries occur in up to 3% of patients with significant blunt abdominal trauma and a slightly…
The introduction of laparoscopy in the 1980s has revolutionized the field of complex abdominal surgery. Once highly morbid procedures requiring open exposure and prolonged recovery are now accomplished through minimally invasive techniques with comparable outcomes. In 1994 Gagner and Pomp…
Pancreatic resection and reconstruction remain a therapeutic challenge to surgeons treating neoplastic disease of the pancreas, distal common bile duct, ampulla of Vater, and proximal duodenum. Despite appreciable improvements in perioperative, postoperative, and intraoperative techniques, morbidity for these procedures remains…
Although pancreatic ductal adenocarcinomas account for approximately 85% of all pancreatic tumors, epithelial tumors of the pancreas are increasingly being identified due to the frequent and improved quality of abdominal imaging modalities, such as computed tomography (CT). Solid pancreatic masses…
Over the past century, clinicians have been challenged by the more frequent identification of primary pancreatic cystic neoplasms (PCNs). Increased use of cross-sectional imaging studies, such as computed tomography and magnetic resonance imaging (MRI), have led to a sustained increased…