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  • Book
    Alberto Martinez-Isla, Lalin Navaratne, editors ; foreword by Lord Darzi of Denham, Peter B. Cotton.
    Summary: This book provides a concise overview of several critically important techniques and their applications within Laparoscopic Common Bile Duct Exploration (LCBDE). LCBDE is rapidly emerging as the preferential management option for treating patients with common bile duct (CBD) stones. Chapters within this book describe how this technique can be applied to manage patients with concomitant gallstones, which aims to increase the exploration of the CBD via the transcystic route. Particular mention is made for the use of energy devices to enable stone fragmentation within the bile duct also known as Lithotripsy-Assisted Bile duct Exploration by Laparoendoscopy (LABEL). Guidance is also provided on how to set-up an acute biliary service which can offer the single-stage management of concomitant gallstones and choledocholithiasis. The concepts of Leveraging Access to Technology and Enhanced Surgical Techniques (LATEST)--in LCBDE and Biliary Surgery 2.0--as the framework through which these techniques can be further enhanced are analysed. Laparoscopic Common Bile Duct Exploration features insight into how to perform these increasingly important procedures successfully and set-up a service within institutions that are yet to provide it. Therefore, it is a valuable resource for all medical professionals involved in the care of these patients.

    Contents:
    History of biliary surgery.-The first cholecystectomy
    The first choledochotomy
    History of common bile duct imaging
    Technique of CBD exploration in the 60s-70s
    The arrival of ERCP
    Approach to the cbd stones in the 80s
    The revolution in the nineties: The laparoscopic cholecystectomy and bile duct exploration
    Review of the evidence against and in favour of LC-IOC±LCBDE
    Our technique & equipment needed
    Equipment and kit needed for LCBDE
    Surgical technique for LCBDE
    Laparoscopic ultrasound
    Different surgical scenarios and its specific management
    Different surgical scenarios
    CBD and CD both non-dilated
    CD Dilated & CBD non-dilated
    CD non-dilated & CBD Dilated
    CD & CBD both dilated
    The impossible hilum: The transinfundibular approach
    The closure after the access to the CBD
    Closure over T -tube
    Closure over antegrade stent
    Primary closure
    Closure with transcystic drain
    Bilioenteric anastomoses
    The LABEL technique
    Our experience with LCBDE in more than 450 cases
    The evolution to Biliary Surgery 2.0
    Our cases.-Failure to clear the duct
    Morbidity
    Closure after exploring CBD
    T tube vs antegrade stent.-Primary closure
    Increase in the use of transcystic approach
    The transcystic vs the TD access.-management of Type II Mirizzi syndrome
    The impact pf LCBDE in a general surgical department.-Bile duct exploration 2.0 .-Training in LCBDE.
    Digital Access Springer 2022