By John L. Cameron, Corinne Sandone, MD, FACS, MA, CMI
The 1st version of this great, two-volume atlas on surgical procedure of the biliary tract, pancreas and liver used to be released approximately twenty years in the past. Dr. Cameron has revisited and up to date this vintage paintings to incorporate laparoscopic thoughts and to illustrate the present prestige of gastrointestinal surgeries. Written for the skilled general practitioner, this two-volume paintings is superbly illustrated with anatomical watercolor work by way of co-author Corinne Sandone that increase the paintings to a degree no longer visible in different atlases. The objective of this quantity is to offer the alimentary tract strategies played and in a few situations initiated on the Johns Hopkins health facility in this kind of style that different alimentary tract surgeons can examine those strategies and practice them effectively.
- Includes operative strategies at the gall bladder and biliary tract, liver (including shunts), pancreas, spleen, and the esophagus.
- Both open and laparoscopic techniques are defined for plenty of of the procedures.
- The paintings offers readability digital camera can't trap, but keeps the realism of the perioperative field.
- Illustrations depict perspectives that can not be photographed: conceptual pictures, cut-away perspectives, and distillations of visible details no longer simply saw within the working room.
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Extra info for Atlas of Gastrointestinal Surgery
These high strictures are more difficult to manage. qxd 8/22/06 3:25 PM Page 43 Resection of a Benign Bile Duct Stricture with Reconstruction Utilizing a Hepaticojejunostomy and these often are found to be responsible for 43 1 the stricture (1). It is our practice to perform preoperative percutaneous transhepatic cholangiography on all patients with a suspected stricture with the insertion of a percutaneous biliary catheter. If the injury is acute, and there are bilo- Cystic duct stump Clip mas or subhepatic abscesses, these are drained percutaneously.
It is closed in two layers; the 7 inner layer is a continuous suture of 3-0 synthetic absorbable material placed in a Connell fashion. Sutures are started at each end and are tied in the middle. The outer layer is a row of interrupted, 3-0 silk, Lembert sutures. The duodenotomy may be drained with a Silastic closed suction drain. This is more for protection in case the sphincteroplasty extends beyond the point where the biliary tree and duodenum share a common wall, rather than protection against leakage from the duodenotomy.
The biliary catheter is then pulled out through the superior surface of the liver, thereby positioning the Silastic transhepatic stent in the right hepatic duct (8). qxd 48 8/22/06 3:26 PM Page 48 Atlas of Gastrointestinal Surgery: Gall Bladder and Biliary Tract If a percutaneous transhepatic biliary catheter has not been placed preoperatively, other techniques are utilized to place the Silastic transhepatic biliary stent. After the proximal biliary segment has been dissected and the stricture resected, the biliary tree can be instrumented with a Randall stone forceps passed up to within 1 cm or 2 cm of Glisson’s capsule.