TY  - CHAP
M1  - Book, Section
TI  - Gallbladder and the Extrahepatic Biliary System
A1  - Pham, Thai H.
A1  - Hunter, John G.
A2  - Brunicardi, F. Charles
A2  - Andersen, Dana K.
A2  - Billiar, Timothy R.
A2  - Dunn, David L.
A2  - Hunter, John G.
A2  - Matthews, Jeffrey B.
A2  - Pollock, Raphael E.
PY  - 2015
T2  - Schwartz's Principles of Surgery, 10e
AB  - The  physiology  of  the  gallbladder  and  sphincter  of  Oddi  is  regulated  by  a  complex  interplay  of  hormones  and  neuronal  inputs  designed  to  coordinate  bile  release  with  food  consumption.  Dysfunctions  related  to  this  activity  are  linked  to  the  development  of  gallbladder  pathologies  described  in  this  chapter.In  Western  countries,  the  most  common  type  of  gallstones  are  cholesterol  stones.  The  pathogenesis  of  these  stones  relates  to  supersaturation  of  bile  with  cholesterol  and  subsequent  precipitation.Laparoscopic  cholecystectomy  has  been  demonstrated  to  be  a  safe  and  effective  alternative  to  open  cholecystectomy  and  has  become  the  treatment  of  choice  for  symptomatic  gallstones.  Knowledge  of  the  various  anatomic  anomalies  of  the  cystic  duct  and  artery  is  helpful  in  guiding  the  dissection  of  these  structures  as  well  as  avoiding  injury  to  the  common  bile  duct  during  cholecystectomy.Common  bile  duct  injuries,  although  uncommon,  can  be  devastating  to  patients.  Proper  exposure  of  Calot’s  triangle  and  careful  identification  of  the  anatomic  structures  are  keys  to  avoiding  these  injuries.  Once  a  bile  duct  injury  is  diagnosed,  the  best  outcomes  are  seen  at  large  referral  centers  with  experienced  biliary  surgeons.The  main  risk  factor  for  gallbladder  disease  in  Western  countries  is  cholelithiasis.  The  main  complications  include  cholecystitis,  choledocholithiasis,  cholangitis,  and  biliary  pancreatitis.  In  addition,  cholelithiasis  plays  the  role  as  the  major  risk  factor  for  the  development  of  gallbladder  cancer.Carcinoma  of  the  gallbladder  and  bile  duct  generally  have  a  poor  prognosis  because  patients  usually  present  late  in  the  disease  process  and  have  poor  response  to  chemotherapy  and  radiation  therapy.  Surgery  offers  the  best  chance  for  survival  and  has  good  long-term  survival  in  patients  with  early-stage  disease.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1117750486
ER  -