Manual of Surgery of the Gallbladder, Bile Ducts, and by Robert E. Hermann M.D. (auth.) PDF

By Robert E. Hermann M.D. (auth.)

ISBN-10: 1461261503

ISBN-13: 9781461261506

ISBN-10: 146126152X

ISBN-13: 9781461261520

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Additional resources for Manual of Surgery of the Gallbladder, Bile Ducts, and Exocrine Pancreas

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Hepatic portoenterostomy (the Kasai operation) for biliary atresia. Surgery, 78, 76. 1975. 20. • Watanabe. I.. : Follow-up studies of long-term survivors after hepatic portoenterostomy for "non-correctable" biliary atresia. J. Pediatr. , 10, 173. 1975. 21. Miyata. • Satani, M .. Veda. T .. : Long-term results of hepatic portoenterostomy for biliary atresia: special reference to postoperative portal hypertension. Surgery, 76,234. 1974. 22. Lilly, J. : The Japanese operation for biliary atresia: remedy or mischief?

The 39 Congenital Anomalies FIGURE 2-13. Type A choledochal cyst seen on intravenous cholangiography in an adult. urogram excludes renal lesions ; the intravenous cholangiogram, if it visualizes, may identify cystic dilatation of the common bile duct (Figure 2-13); barium studies of the stomach may show displacement of the antrum of the stomach or duodenum. In addition, an ultrasonic scan or computed tomography (CT) may identify the presence of a cystic mass beneath the liver. In the teenage or adult patient, selective celiac and superior mesenteric arteriograms may help determine the site and size of the mass and its relation to the liver.

In my opinion, cholecystectomy should not be performed in the infant or very young child, especially if it is hazardous or likely to prolong unduly the operative procedure. Excision of the choledochal cyst is not recommended because it would require resection of the entire common bile duct. For cystic diverticula (type B anomalies), excision of the cyst may be considered. Excision of the cyst should only be performed in the patient with type B deformity; in patients with type A or type C deformity the operation is hazardous and has been associated with a high mortality rate.

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Manual of Surgery of the Gallbladder, Bile Ducts, and Exocrine Pancreas by Robert E. Hermann M.D. (auth.)


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