Laparoscopic Common Bile Duct Exploration (In Clinical Practice)

Foreword by Lord Darzi of Denham
Foreword by Peter B. Cotton
References
Preface
Acknowledgments
Contents
Chapter 1: History of Bile Duct Surgery
	The First Cholecystectomy
	The First Choledochotomy
	History of Common Bile Duct Imaging
	Technique of Bile Duct Exploration in the 1960s and 1970s
	The Arrival of Endoscopic Retrograde Cholangiopancreatography (ERCP)
	Approach to Common Bile Duct Stones in the 1980s
	The Revolution in the 1990s: Laparoscopic Cholecystectomy and Bile Duct Exploration
	References
Chapter 2: Review of the Evidence for Laparoscopic Bile Duct Exploration (LBDE)
	Introduction
	Stone Clearance
	Morbidity
		Bile Leak
		Post-Procedural Pancreatitis
	Hospital Stay and Cost
	Learning Curve and Teaching
	References
Chapter 3: Laparoscopic Biliary Ultrasound
	Equipment
	Principles of Imaging Acquisition
	Principles and Technique of Picture Acquisition
	Documentation and Pathology
	Business Case
	References
Chapter 4: Equipment and Operative Setting for Laparoscopic Bile Duct Exploration (LBDE)
	Equipment
		Intra-Operative Cholangiogram (IOC)
		Retraction of the Liver
		Choledochoscopes
			Scope Fatigue
			Scope Failure
		Laser Lithotripsy
		Electrohydraulic Lithotripsy (EHL)
	Operative Setting
		Patient Position
		Port Placement
		Cholecystectomy
		Intra-Operative Cholangiogram (IOC)
		Choledochoscopy
	References
Chapter 5: Lithotripsy Assisted Bile Duct Exploration by Laparoendoscopy (LABEL)
	Modes of Lithotripsy
	What Is the Evidence for Lithotripsy during LBDE?
	Which Patients Might Require LABEL?
	Surgical Technique for LABEL
		Passing the Laser Probe Through the Working Channel of the Choledochoscope
		Aiming at the Stone
		Fragmentation vs Powderization
		Rate of Irrigation
		Damage to the Laser Fibre
		Iatrogenic Injury to the Bile Duct Mucosa
	References
Chapter 6: Operative Techniques in Laparoscopic Bile Duct Exploration
	Different Scenarios in LBDE
		Scenario 1: Both the Cystic Duct and CBD Are Not Dilated
		Scenario 2: The Cystic Duct Is Dilated But the CBD Is Not Dilated
		Scenario 3: The Cystic Duct Is Not Dilated But the CBD Is Dilated
		Scenario 4: Both the Cystic Duct and CBD Are Dilated
		Scenario 5: The Impossible Hilum: Trans-Infundibular Approach (TIA) to the Bile Duct
	Closure After Accessing the Bile Duct
		Closure of the Choledochotomy
			Closure Over a T-Tube
			Closure Over an Antegrade Stent
			Primary Closure (Without Transcystic Drain)
			Primary Closure with Trancystic Drain
			Bilioenteric Anastomosis
		Closure After the Transcystic Approach
	Bile Duct Exploration in the Patient with Roux-En-Y Gastric Bypass (RYGB)
	References
Chapter 7: Our Experience of Laparoscopic Bile Duct Exploration from Nearly 500 Cases: Leveraging Access to Technology and Enhanced Surgical Technique (LATEST) and the Biliary Surgery 2.0 Concept
	Our Series
	CBD Clearance
	Morbidity
	Closure After Accessing the CBD
		T-Tube vs Antegrade Stent
		Primary Closure
	Achieving Higher Rates of Transcystic LBDE: Leveraging Access to Technology and Enhanced Surgical Technique (LATEST)
		3 mm Choledochoscopes
		Lithotripsy-Assisted Bile Duct Exploration by Laparoendoscopy (LABEL)
		Trans-Infundibular Approach (TIA) to the Bile Duct
	Transcystic Vs Transductal Access
	Management of Type II Mirizzi Syndrome
	The Impact of LBDE in a General Surgery Department
	Biliary Surgery 2.0 Concept
	References
Chapter 8: Training in Laparoscopic Bile Duct Exploration (LBDE)
	Trends in the Utility of Laparoscopic Bile Duct Exploration (LBDE)
	Simulation Training in LBDE: The Porcine Aorto-Renal Artery (PARA) Model
	Modular Training in Laparoscopic Bile Duct Exploration (LBDE)
	Gaining Competency in LBDE
	References