The Management of Gallstone Disease


Book Description

This book looks at the comprehensive management of all aspects of gallstone disease, from the epidemiology and pathogenesis to the complex management approaches required for some patients. The main emphasis is placed on effective diagnosis and treatment, making extensive use of practical case-based material while reviewing the guidelines in a multi-disciplinary manner. It is an essential read for all clinicians involved in managing patients with gallstone disease.




Gallstone Disease and its Management


Book Description

Exciting major changes have occurred in the understanding and treatment of gallstone disease over the last two decades. In bygone years, books about gallstones were often based on postgraduate lectures which the author, usually a surgeon of distinction, had given. More recently, many books dealing with this subject have been based upon national or international conferences. The single-author text has the disadvantage that few authors today can authoritatively encompass a whole field: the reports of symposia, conferences or workshops often lack balance and auth ority. The merits of 'Gallstone disease and its Management' edited by Malcolm Bateson are clear. He has chosen 11 authors, all of whom write on topics relating to their own expertise, and the content of the book has been carefully planned to reflect the most modern ideas about the aetiology and management of cholesterol gallstones. It is worth repeating that we are experiencing rapid developments in the field of gallstone disease. Disappointingly the least progress has been made in identifying the cause (or causes) of the disease notwithstanding the many data implicating a variety of environmental factors. Most of these affect the chemistry of hepatic bile and the contribution of the gallbladder to lithogenesis remains uncertain and unstudied.







Gallstone Disease


Book Description

The nonsurgical management of gallstone disease has drawn widespread clinical interest during the last decade as ultrasound surveys have indicated that cholelithiasis is predom inantly an asymptomatic condition and much more prevalent than previously thought. This book presents an overview of the pathophysiologic and pathobiochemical principles of gallstone formation and the consequences for clinical therapeutic regimens. New information concerning the balance between vesicular and micellar transport of choles terol, early cholesterol nucleation, and the influence of inhibiting and promoting com pounds for cholesterol nucleation as well as information concerning the effects of changes in gallbladder motility and gallbladder mucosal function is reviewed. In order to make further progress in developing treatments which facilitate gallstone dissolution and in preventing disease, it is necessary to integrate this new data into our thinking. Methods of treatment such as systemic litholysis of cholesterol gallbladder stones with bile acid preparations and mechanical fragmentation of stones either by extracorpo ral shock waves or intracorporal laser systems are carefully described and separate discussions of direct contact litholysis of cholesterol stones with ether preparations and the local litholytic treatment of calcified pigment stones are included. New therapeutic applications of HMG-CoA-reductase inhibitors and nonsteroidal anti-inflammatory drugs are also critically reviewed. Finally, for the interested reader an evaluation of prophylactic treatment against stone recurrence after successful conservative treatment and an appraisal of alternative management strategies supplement the information on the conservative treatment of gallstones.




Diseases of the Gallbladder and Bile Ducts


Book Description

An interdisciplinary reference book for the diagnosis and treatment of gallbladder and bile duct diseases With recent developments in the management of hepatobiliary diseases including liver transplantation, this new edition aids all members of the team by addressing both the biliary indications for and biliary complications of these procedures. It's divided into three sections on anatomy, pathophysiology, and epidemiology; diagnostic and therapeutic approaches including the latest therapeutic modalities; and specific conditions. Includes more than 250 illustrations for rapid reference. Each chapter now has a Q&A section and begins with a list of objectives outlining the chapter’s goals. In addition, a number of new imaging modalities are presented in this new edition. It takes an integrated medical, surgical and radiological approach, making this invaluable to all members of the team who deal with complications of liver transplantation and the management of patients.




Gallstones


Book Description

Gallstone disease is one of the most prevalent digestive diseases, resulting in a considerable amount of financial and social burden in the USA. Approximately 20 million Americans have gallstones. Because gallstone disease is a common clinical problem, basic and clinical studies on this disease continue to advance at a rapid pace, and a book focusing on basic science, current diagnosis and management of gallstones will greatly help practicing gastroenterologists, gastroenterological endoscopists, physicians and surgeons to understand the etiology of this disease and the availability of effective medical therapies. In this book, recognised medical experts discuss recent advances in the epidemiology, pathophysiology, pathogenesis, genetics and diagnosis, as well as endoscopic, medical and surgical therapies of gallstone disease. This compilation on gallstone disease was written by fifty authors from eight countries (Canada, China, Germany, Italy, Japan, the Netherlands, the United Kingdom, and the USA). There are thirty chapters in this book. Chapters One and Two discuss the epidemiology and natural history of cholesterol and pigment gallstone disease. Chapters Three through Six summarise recent progress in the pathogenesis of gallstone disease from a physical-chemical and pathophysiological perspective. Chapter Seven elucidates the roles of the immune system and the microbiome on the pathogenesis of cholesterol gallstones. Chapters Eight and Nine review the roles of nuclear receptors and the enterohepatic circulation of bile acids in cholesterol gallstone diseases. Chapters Ten through Twelve discuss the discovery of Lith genes and more fundamental knowledge concerning the genetic determinants and the molecular mechanisms underlying the critical role of Lith genes in gallstone formation in mice and humans. Chapter Thirteen discusses gallstones in pregnancy and explains why gallstone prevalence is higher in women than in men. Chapters Fourteen through Eighteen discuss the effects of diet, insulin resistance, obesity, diabetes, and nonalcoholic fatty liver disease on the formation of cholesterol gallstones. Chapter Nineteen provides diagnostic flow charts for biliary lithiasis. In Chapter Twenty, important non-invasive imaging findings of common gallbladder pathology are reviewed, and current strategies for the optimal use of imaging in the evaluation of patients with suspected gallbladder disease is discussed. Chapter Twenty-One evaluates current pharmacological therapy in cholesterol gallstones. Chapter Twenty-Two describes laparoscopic cholecystectomy. Chapters Twenty-Three through Twenty-Six discuss surgical treatment and endoscopic management of common bile duct stones and hepatolithiasis. Chapter Twenty-Seven reviews recent progress on the endoscopic treatment of bile duct stones with endoscopic papillary large balloon dilation. Chapter Twenty-Eight addresses surgical treatment of gallstones and their complications. Chapter Twenty-Nine discusses treatment of intrahepatic duct stones from a Western perspective. Chapter Thirty describes the history and incidence rate of Mirizzi syndrome, and summarises recent progress in its classification, diagnosis, and management. The articles in this book provide a state-of-the-art review of the current knowledge on the lithogenesis and the management of gallstone disease, as well as promote future epidemiological investigation, basic and translational research, and clinical studies on this prevalent biliary disorder worldwide.




Textbook of Surgery


Book Description

Textbook of Surgery is a core book for medical and surgicalstudents providing a comprehensive overview of general andspeciality surgery. Each topic is written by an expert in thefield. The book focuses on the principles and techniques of surgicalmanagement of common diseases. Great emphasis is placed onproblem-solving to guide students and junior doctors through theirsurgical training. Throughout the book are numerous reproducible line drawings,tables and boxes that will prove invaluable for learning andrevision. In addition there are detailed guidelines provided forsurgical management. Up-to-date and ideal for medical students and junior doctors onsurgical attachments and a perfect refresher for RACS and MRCScandidates. Reviews of the last edition “The textbook presents a compact and contemporary overviewand is not so much a reference book as a working tome suitable forfamiliarization with current trends in treatment and diagnosis inthese various areas. …found this textbook very informative and a pleasure toread.” ANZ Journal of Surgery Vol. 72, No. 12.




Gallstone Formation, Diagnosis, Treatment and Prevention


Book Description

Gallstone Formation, Diagnosis, Treatment, and Prevention describes the current scenario of gallstones and adopted treatment methods. It is a complete reference for researchers introducing new techniques to help prevent extreme treatments such as a cholecystectomy. This reference provides current knowledge and basic challenges of understanding gallstone formation, with all variations of composition including complications of the treatment process. This content directs researchers to focus on gallstone mechanisms to design and develop new treatment methods. The book provides all possible factors for gallstone formation as well as preventative measures. Offers treatment methods, including both chemical and herbal methods Presents mechanisms behind gallstone formation that are important to researchers to determine treatment methods that can prevent cholecystectomy Includes the latest research on acute pancreatitis, one of the major concerns of gastrointestinal disease Discusses the effects of gallstone as a cancer-causing mechanism




Gallstones


Book Description

This book, the proceedings of the Falk Syposium No. 139 on "Gallstones: Pathogenesis and Treatment", held in Freiburg, Germany, on January 15-16, 2004, reflects the tremendous advances in the field of biliary diseases both at the genetic and cellular as well as the clinical levels. In industrialized countries, gallstones are a frequent clinical entity with a prevalence of 10-15%. In clinical practice one can differentiate between cholesterol stones, black pigment stones and brown pigment stones. 80-90% of gallbladder stones are cholesterol stones, 10--20% are black pigment stones. The prevalence of cholesterol stones increases with age and in Europe in the 70+ age group reaches about 20% in males and about 30% in females. Gallstones and gallstone diseases, therefore, are a frequent and important clinical problem. The book addresses the basic aspects of gallstone pathogenesis as well as the non-surgical and surgical treatment of gallstone diseases. Of particular interest are the epidemiology and genetics of gallstone formation, with definition of risk factors, in particular of genetic predispositions. Other major aspects are the hepatocellular and bilary transport mechanisms that predispose to the formation of gallstones. Apart from cholesterol and lipid transport and absorption, gallbladder function plays a central role in gallstone formation. Another clinically very relevant topic is the treatment of gallstone diseases by drugs, endoscopic and other non-surgical interventions, and surgery, as well as the long-term outcome of therapeutic interventions. The volume concludes with a state-of-the-art chapter on "Gallstone Research in the Post-Genomic Era". Gallstones: Pathogenesis and Treatment is an excellent update on the pathogenesis of gallstones as well as on the treatment of gallstone diseases, written by an international faculty of outstanding clinicans and scientists. The book will, therefore, be of great interest to hepatologists and gastroenterologists in academic institutions as well as in clinical practice.




Biliary Lithiasis


Book Description

The first laparoscopic cholecystectomy, performed by Prof. Philippe Mouret in 1987 and described by himself in the first chapter of this book, was an event that revolutionized surgery in the past few decades. Although the majority of surgeons today are unfamiliar with the his- ry of early minimally invasive surgery developments, it is important to realize that the advent of laparoscopy led not only to new surgical te- niques, but also to a change in the doctrine of medical care, by streng- ening the concept of minimal invasiveness. This is particularly the case for biliary lithiasis, for which laparoscopy has provided major benefits in terms of both diagnosis and surgical tre- ment. However, our understanding of the etiology of this disease, as well as the availability of effective medical therapies, have remained subst- tially unchanged over time. The application of the innovative approach has not been, in routine practice, without problems: between 1990 and 2000, the rate of serious complications from laparoscopic cholecystectomy were four times higher than those observed with open surgery. Even initial attempts at lapa- scopic treatment of biliary common bile duct stones resulted in excessive complications and associated medico-legal problems. Nonetheless, today, most indications have been stated, techniques have been standardized, and a new aspect to the treatment of biliary lithiasis has appeared.