This volume covers the pathophysiology, epidemiology, presentation, diagnosis, medical and surgical management of benign biliary stenosis. The book is uniquely structured in a way that allows areas of controversy to be highlighted through the use of a two chapter format for each topic. Each chapter topic is written by an expert in the field, with a second expert highlighting controversies and offering opposing viewpoints and treatment paradigms through a counterpoint chapter immediately following the primary chapter. The volume also features an array of diagrams and illustrations. As an authoritative text on the clinical care of patients with benign biliary stenosis, Management of Benign Biliary Stenosis and Injury: A Comprehensive Guide is a valuable resource for all practitioners involved in the care of these patients, including gastroenterologists, gastrointestinal surgeons, surgical oncologists, and transplant physicians.​

This unique book is the first to focus on diagnostic and therapeutic endoscopy in gastrointestinal and pancreatico-biliary diseases. It provides an in-depth overview of the state of the art in diagnostic and therapeutic endoscopy of both the digestive tract and the pancreatico-biliary ductal system, and documents the latest innovations in the field. The first part of the book addresses advanced diagnostic and therapeutic endoscopy of the digestive tract, discussing bariatric endoscopic surgery, and the treatment of neoplasia and precancerous lesions of the upper and lower GI tract, motor disorders, GERD, strictures, fistulae and bleeding. The second part of the book is explores ERCP and EUS procedures, covering the diagnosis and therapy of biliary ductal system and pancreatic diseases. Each chapter includes an abundance of color images that document in detail the devices, operative techniques and outcomes. Written by leading internationally renowned experts, the book is a valuable resource for both specialists and residents in gastroenterology and surgery.

Bile duct injuries (BDI) are considered the most serious surgical complication associated with cholecystectomy. According to different reports, its incidence has remained constant over the years, ranging from 0.1% to 0.9%. BDI is associated with a greater risk of perioperative morbidity and mortality, a reduction in the quality of life, and a decrease in long-term survival. Also, this complication is a concern to surgeons since its progression is uncertain and may lead to demands on professional responsibility ("malpractice") and emotional and physical consequences ("second victim"). Given that injuries in a high percentage of patients are initially unsuspected, the postoperative recovery may be prolonged, and the possibility of a successful repair reduced. Several surgical, endoscopic, and percutaneous procedures may be necessary to manage the lesions and to treat coexisting complications. BDI patients often undergo several repair attempts before successful resolution. This affects their quality of life and has a high psychological, physical, and mental impact due to the prolonged, complex, and unexpected nature of the injury. This currently represents a frequent problem in specialized referral centers or hepatobilopancreatic surgery units, where patients arrive with the sequelae of previous inadequate treatments. Usually, these patients require more elaborate procedures such as reoperations, liver resections and liver transplantation. The prevention, early diagnosis, and adequate treatment in the first approach is of crucial importance to ensure good long-term results. Therefore, this book is an essential resource for surgeons who perform cholecystectomy or treat BDI patients. It provides practical information and a comprehensive review on prevention and proper management, including complex cases. Readers will find contributions by experienced authors from a multidisciplinary and reference team in the management of BDI patients.

The Roux-en-Y Hepatica-jejunotomy (RYHJ) is considered the gold standard of care in iatrogenic complex bile duct injury. The RYHJ will lead to stricture in 4 to 10% of cases. Redo surgery, endoscopy and percutaneous cholangiography are the three available therapeutic options. Nowadays, the majority of these strictures are managed by biliary drainage and balloon dilatation as a first approach. The duration of biliary drainage as well as the baboon calibration is still controversial. In this article we discuss the use of cutting balloon in 8 cases as a first approach to manage benign biliary stenosis after R YHJ.

This book provides detailed insight to the readers into various aspects of bile duct injury. Bile duct injury is a common complication of cholecystectomy to treat gall stone disease prevalent all over the world. Risk of bile duct injury is more during a laparoscopic procedure as compared to open procedure and most cholecystectomies today are performed laparoscopically. Bile duct injury causes major morbidity and may even result in death, additionally it increases the healthcare costs and impairs quality of life. It is therefore important that every surgeon who performs cholecystectomy knows how to suspect, diagnose, manage and prevent bile duct injury. This book provides practical information and offers assistance in managing patients with difficult cases of bile duct injury. It summarises Dr Kapoor’s experience with management of more than 1,000 patients with post-cholecystectomy bile duct injury/ biliary stricture. Chapters cover anatomy, epidemiology, mechanism, pathophysiology, clinical presentation, investigations, classification, diagnosis, management and prevention of bile duct injury. It also includes non-medical issues including health care, socio-economic, costs and quality of life.

This book aims to raise awareness of IgG4-related sclerosing cholangitis among practicing physicians and to equip readers with a sound understanding of the principles of diagnosis and treatment. Clinical, serological, and histopathological features are clearly described and imaging appearances on all relevant modalities are illustrated, covering the bile duct and other involved organs. Differential diagnosis from other diseases, including primary sclerosing cholangitis and cholangiocarcinoma, is precisely explained. Information is then presented on all significant current and emerging therapeutic strategies, including steroids, immunosuppressive drugs, and rituximab. Finally, attention is drawn to significant prognostic features. While IgG4-related sclerosing cholangitis is now a widely acknowledged condition, most practitioners are still liable to misdiagnose it owing to a lack of familiarity with its presenting features. This book should help to rectify the situation and will be an asset for all who may encounter the disease in clinical practice.

This book presents a comprehensive collection of classic cases and problem scenarios encountered as bedside case discussions during ward rounds. It facilitates the practical management of hepatic disorders. The unique aspect of hepatology involves the blend of the basic tenet of clinical medicine applied to liver disease and a multitude of interventional modalities in the management of liver, biliary, and pancreatic diseases. This book takes the reader through the process of ruling in and ruling out possibilities based on clinical data (history and examination) and then traces the logical trajectory of each case from recommended investigations to the analysis of test results and finally to making a syndromic diagnosis. By adopting an evidence-based approach, the book emphasizes analytical and need-based studies to exclude any mimics. This book helps practice hepatologists and gastroenterologists for a systematic approach towards the most common cases.

This book provides a comprehensive overview of non-surgical treatments for complicated and refractory biliary and pancreatic lesions. In particular, it offers non-surgical treatment options for benign biliary strictures. For those suffering from intractable total biliary obstruction following biliary operation, magnetic compression anastomosis represents a good therapeutic option, and this technique is fully explained. Moreover, the book describes diverse treatment modalities for hilar stricture, which is one of the most challenging areas of ERCP. Several chapters cover a variety of important aspects of this area. The book also aims to identify and solve the unmet needs for the diagnosis and treatment of biliary and pancreatic diseases. The precise explanations of treatment concepts and strategies will both increase readers’ knowledge and provide assistance in daily clinical practice. The authors are pioneering experts from around the world, and the text is supported by numerous informative illustrations and helpful summaries.

Although benign biliary disease is an area in which many surgeons have experience, there are many nuances to providing the highest quality of surgical care. The biliary anatomy is unique but presents with anatomical variances and can be distorted by benign pathology. Biliary surgery has been one of the areas where minimally invasive techniques were first applied in the late 1980s. However, surgical technique has continued to evolve due to acquisition of advanced minimal surgical skills and improvement in surgical technology. The expertise, sage, and knowledge of the members of the Society of American Gastrointestinal and Endoscopic Surgery (SAGES) have prioritized the creation of this manual on modern biliary surgery. This manual will provide the standard for the current state of biliary surgery in the 21st century. The SAGES Manual of Biliary Surgery will align with the new SAGES University Masters program. The Manual supplements the Masters Program Biliary Surgery Pathway. Its goal is to help the surgeon progress from the competent to the proficient and finally to the mastery level. Both for the surgical trainee and senior surgeon, this guidebook will also give insight into modern evaluation and management. The highlights will emphasize what is both feasible and safe from a minimally invasive approach in biliary surgery. The concept of Safe Cholecystectomy will be defined and expounded on in detail. The difficult cholecystectomy will be given ample coverage to include management of intraoperative bile duct injury, indications and techniques of subtotal cholecystectomy, and special attention to intraoperative diagnostic imaging that serve as adjuncts, including cholangiograpy, ultrasound, as well as indocyanine green biliary fluorescence. We will review the updated international Tokyo guidelines for acute cholecystitis. Furthermore, the evolution of treatment of choledocohlithiasis has evolved the most in recent years, and thus requires an extensive discussion of the non-operative and operative management of bile duct stones. This text will serve as an important contribution to the medical literature sponsored by SAGES, an international leading authority in gastrointestinal surgery with a keen interest in safe and proficient biliary surgery. Leaders in the field of biliary surgery will impart their insight and considerable experience in the chapters planned for this manual. The intent for this manual is to be the cited resource for high quality and applicable knowledge for the treatment of benign biliary disease.