Portacaval and Distal Splenorenal Shunts A variety of portasystemic shunt procedures have been devised, attesting to dissatisfaction with the side effects. Most patients with bleeding esophageal varices are managed by…
Ampullary Resection for Tumor This procedure is used in highly selected cases, primarily for benign tumors such as villous adenomas that are not amenable to endoscopic resection. It is sometimes…
Transduodenal Sphincteroplasty Sphincteroplasty is a useful adjunct to bile duct exploration for calculous biliary tract disease. It produces a wide opening of the distal bile duct, allowing impacted stones to…
Laparoscopic Biliary Bypass Laparoscopic cholecystojejunostomy is a simple procedure that is described in this chapter. Other, more complex forms of biliary diversion have also been performed laparoscopically and are referenced…
Choledochoduodenostomy and Other Biliary Bypass Procedures Choledochoduodenostomy is performed when multiple stones have been found in the common duct at exploration and when it appears unlikely that complete removal of…
Laparoscopic Cholecystectomy, Common Bile Duct Exploration, and Liver Biopsy Laparoscopic cholecystectomy introduced operative laparoscopy to most general surgeons, and is often the first laparoscopic procedure performed by surgical residents. Although…
Cholecystectomy, Common Bile Duct Exploration, and Liver Biopsy The safest way to perform an open cholecystectomy is from the top down, rather than retrograde (bottom up), as is done during…
Introduction This section is organized into two parts: the extrahepatic biliary tract (and liver) and the pancreas. Within each part, simple procedures are described first, followed by a discussion of…
Laparoscopic Splenectomy Laparoscopic splenectomy is easiest for small spleens (for example, the normal sized spleen associated with idiopathic thrombocytopenic purpura [ITP]). Techniques have been developed for moderate to large sized…
Splenectomy and Splenorrhaphy Total splenectomy is performed for hematologic indications and for traumatic injury. Special techniques for repairing the injured spleen are discussed in Figs. 61.8 and 61.9. A staging…
