Pancreatic Necrosectomy (Open and Laparoscopic) Severe (necrotizing) pancreatitis results in collections of necrotic tissue in the retroperitoneum. When these become infected, antibiotics and drainage are required. In the majority of…
Internal Drainage of Pancreatic Pseudocysts Pancreatic pseudocysts form when collections of fluid become loculated in the region of the pancreas and fail to reabsorb, becoming chronic. The term “pseudocyst” reflects…
Laparoscopic Distal Pancreatectomy James J. Mezhir Minimally invasive approaches to pancreatectomy have been demonstrated to be safe and oncologically equivalent in selected patients and in the hands of experienced surgeons….
Pancreatic Resections James J. Mezhir This chapter discusses distal (left) pancreatectomy and pancreaticoduodenectomy (Whipple procedure). Because of the close anatomic proximity of the body and tail of pancreas to the…
Major Hepatic Resection Neal Wilkinson Hepatic resections are performed for benign and malignant conditions. Hepatic adenoma, hemangioma, and focal nodular hyperplasia are all benign mass lesions that the surgeon may…
Drainage of Hepatic Abscess James J. Mezhir This chapter discusses open and laparoscopic approaches to the drainage of pyogenic hepatic abscess. Currently, most liver abscesses are drained percutaneously under ultrasound…
Liver Biopsy—Open and Laparoscopic Liver biopsy is generally performed as part of another procedure in order to document pathology. Common indications include nodules suggestive of metastatic disease or the unexpected…
Portacaval and Distal Splenorenal Shunts A variety of portosystemic 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…
