By John L. Cameron, Corinne Sandone, MD, FACS, MA, CMI
The 1st version of this very good, two-volume atlas on surgical procedure of the biliary tract, pancreas and liver was once released approximately twenty years in the past. Dr. Cameron has revisited and up to date this vintage paintings to incorporate laparoscopic thoughts and to illustrate the present prestige of gastrointestinal surgeries. Written for the skilled general practitioner, this two-volume paintings is superbly illustrated with anatomical watercolor work by means of co-author Corinne Sandone that increase the paintings to a degree no longer noticeable in different atlases. The target of this quantity is to give the alimentary tract strategies played and in a few situations initiated on the Johns Hopkins health center in this sort of type that different alimentary tract surgeons can research those recommendations and practice them effectively.
- Includes operative techniques at the gall bladder and biliary tract, liver (including shunts), pancreas, spleen, and the esophagus.
- Both open and laparoscopic techniques are defined for plenty of of the procedures.
- The paintings presents readability digicam can't trap, but continues the realism of the perioperative field.
- Illustrations depict perspectives that can't be photographed: conceptual photographs, cut-away perspectives, and distillations of visible details no longer simply saw within the working room.
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Extra resources for Atlas of Gastrointestinal Surgery
Performing a sideto-side choledochoduodenostomy will allow any retained stones to pass spontaneously. In the past, the most common indication for the procedure has been for primary or recurrent common duct stones. Following choledochotomy and stone extraction, a side-to-side choledochoduodenostomy has been advocated by many for primary common duct stones to prevent recurrent stone formation or to allow recurrent stones to pass spontaneously if they do recur. Today, most patients with primary common duct stones are treated by endoscopic papillotomy.
Sphincteroplasty has also been utilized for calculus disease of the biliary tree. If, after a common duct exploration, the surgeon is not certain that all of the stones have been removed, some surgeons open the duodenum and perform a sphincteroplasty so that any retained stones might pass spontaneously. It is still used for patients who have an impacted distal common duct stone that cannot be retrieved from above through a choledochotomy, or from below via endoscopic papillotomy. A sphincterotomy is performed to dislodge the stone, and most surgeons will proceed to extend the incision and convert it into a formal sphincteroplasty.
However, if the cholecystectomy was for acute cholecystitis, or if there has been bile leakage from the gall bladder bed in the liver, leaving a closed suction Silastic drain is appropriate. Many studies have shown drains to be unnecessary following cholecystectomy. The only reason for leaving a drain behind is if an unexpected bile leak occurs from a small unrecognized bile ductule in the bed of the liver. Leaving a drain in place obviates the need for percutaneous Gall bladder fossa drainage if a biloma or abscess occurs.