Biliary Lithiasis: Basic Science, Current Diagnosis and Management

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Giuseppe Borzellino, Claudio Cordiano
Springer Science & Business Media, Nov 27, 2008 - Medical - 513 pages
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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.
 

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Contents

Reflections on the Birth and on the Concept of Laparoscopic Surgery
1
Epidemiology of Biliary Lithiasis
13
Pathophysiology of Cholesterol Gallstone Disease
19
Classification Composition and Structure of Gallstones Relevance of these Parameters for Clinical Presentation and Treatment
50
Natural History of Biliary Lithiasis
67
Preoperative Noninvasive Imaging
75
Threedimensional Imaging
93
Endoscopic Retrograde Cholangiopancreatography and Endoscopic Ultrasound
104
Synchronous Treatment of Common Bile Duct Stones by Laparotomy
317
Cholecystocholedocholithiasis Twostage Treatment
325
Synchronous Treatment of Common Bile Duct Stones by Laparoscopy
340
Rendezvous Technique
351
Flow Chart for the Treatment of CBDS and Critical Comparison of Techniques
357
Common Bile Duct Stones in Cholecystectomized Patients
365
Acute Biliary Pancreatitis
383
Incidence and Management of Mirizzi Syndrome
393

Pre and Intraoperative Diagnostic Fibrocholangioscopy
115
Intraoperative Cholangiography
123
Laparoscopic Ultrasound during Laparoscopic Cholecystectomy
130
Diagnostic Flow Charts for Biliary Lithiasis
143
Medical Treatment of Gallstone Disease
149
Surgical Treatment of Cholelithiasis Exclusion Criteria
158
Anesthesia in Biliary Lithiasis
175
Cholecystectomy Techniques
184
Robotassisted Cholecystectomy
209
Day Surgery Laparoscopic Cholecystectomy
217
Diagnosis and Treatment of Acute Cholecystitis
237
Incidental Carcinoma of the Gallbladder
248
Complications of Laparoscopic Cholecystectomy
255
Clinical Pictures of Common Bile Duct Stones
310
Biliary Lithiasis in Children
401
Biliary Lithiasis in Pregnancy
409
Biliary Lithiasis and Obesity
414
Biliary Lithiasis in Patients with Gastroesophageal Reflux Acid and Alkaline
425
Hepatic Cirrhosis and Biliary Stones
435
Biliary Stones and Gastrectomy
439
Biliary Ileus
449
Clinical Pictures of Intrahepatic Lithiasis
455
Treatment of Intrahepatic Lithiasis
466
Extracorporeal Shock Wave Treatment of Gallbladder Stones
479
Shock Wave for Main Bile Duct Stones
489
Acute Gallstone Cholangitis Clinical Pictures Diagnosis and Treatment
496
SUBJECT INDEX
509
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