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…

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…

Laparoscopic Roux-en-Y Gastric Bypass James W. Maher Laparoscopic Roux-en-Y gastric bypass, one of the most technically demanding laparoscopic procedures, is emerging as the preferred method for treating morbid obesity when…

Laparoscopic Adjustable Gastric Banding The adjustable gastric band is designed to divide the stomach into a small upper pouch of approximately 15 mL that can empty only gradually into the…