Biliary Lithiasis

The aim of the book is to provide an overview on biliary lithiasis, twenty years after the first laparoscopic cholecystectomy. The most important feature of the book is that all of the possible diagnostic and therapeutic approaches are illustrated.

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.

Provides a complete overview on biliary lithiasis

Klappentext

The book provides an overview on biliary lithiasis and all its clinical pictures, twenty years after the first laparoscopic cholecystectomy. The gallbladder, the main bile duct and intra-hepatic stones, in their uncomplicated and complicated forms are illustrated. Chapters are focused on basic science, epidemiology, diagnostic and therapeutic approaches to biliary lithiasis. The different diagnostic procedures described include invasive and noninvasive imaging, and treatment options take into consideration medical treatment, open and minimally invasive surgery, endoscopic and percutaneous approaches, both individually and as combined procedures.

The book's content is not limited to the most commonly used therapeutic approaches reported in the literature, but also addresses new and innovative therapeutic strategies for biliary lithiasis.

Thanks to its comprehensive approach, this volume will be of interest not only for GPs amd specialists in this field, but also to residents and other health professional of different disciplines.

Inhalt
Reflections on the Birth and on the Concept of Laparoscopic Surgery.- Epidemiology of Biliary Lithiasis.- Pathophysiology of Cholesterol Gallstone Disease.- Classification, Composition and Structure of Gallstones. Relevance of these Parameters for Clinical Presentation and Treatment.- Natural History of Biliary Lithiasis.- Preoperative Noninvasive Imaging.- Three-dimensional Imaging.- Endoscopic Retrograde Cholangiopancreatography and Endoscopic Ultrasound.- Pre- and Intra-operative Diagnostic Fibrocholangioscopy.- Intraoperative Cholangiography.- Laparoscopic Ultrasound during Laparoscopic Cholecystectomy.- Diagnostic Flow Charts for Biliary Lithiasis.- Medical Treatment of Gallstone Disease.- Surgical Treatment of Cholelithiasis: Exclusion Criteria.- Anesthesia in Biliary Lithiasis.- Cholecystectomy Techniques.- Robot-assisted Cholecystectomy.- Day Surgery Laparoscopic Cholecystectomy.- Diagnosis and Treatment of Acute Cholecystitis.- Incidental Carcinoma of the Gallbladder.- Complications of Laparoscopic Cholecystectomy.- Clinical Pictures of Common Bile Duct Stones.- Synchronous Treatment of Common Bile Duct Stones by Laparotomy.- Cholecystocholedocholithiasis: Two-stage Treatment.- Synchronous Treatment of Common Bile Duct Stones by Laparoscopy.- Rendez-vous Technique.- Flow Chart for the Treatment of CBDS and Critical Comparison of Techniques.- Common Bile Duct Stones in Cholecystectomized Patients.- Acute Biliary Pancreatitis.- Incidence and Management of Mirizzi Syndrome.- Biliary Lithiasis in Children.- Biliary Lithiasis in Pregnancy.- Biliary Lithiasis and Obesity.- Biliary Lithiasis in Patients with Gastroesophageal Reflux (Acid and Alkaline).- Hepatic Cirrhosis and Biliary Stones.- Biliary Stones and Gastrectomy.- Biliary Ileus.- Clinical Pictures of Intrahepatic Lithiasis.- Treatment of Intrahepatic Lithiasis.- Extracorporeal Shock Wave Treatment of Gallbladder Stones.- Shock Wave for Main Bile Duct Stones.- Acute Gallstone Cholangitis: Clinical Pictures, Diagnosis and Treatment.