Gallbladder and Pancreas

Matthew B. Singer, Andrew Tang

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

This is a unique question-and-answer chapter for surgical residents and trainees, concentrating on the injuries of gallbladder and pancreas. A minority of bile duct injuries are recognized during the index cholecystectomy, only about 25% in most series. There are several factors that facilitate recognition of intraoperative injury, but the most important is a change in the surgeon's awareness to suspect and/or evaluate a bile duct injury. The primary non-operative diagnostic modality for pancreatic injury is CT scanning. CT scan evidence of pancreatic transection or extensive peri-pancreatic fluid warrants laparotomy. These findings are associated with a higher risk of pancreatic ductal disruption, which is the major determinant of prognosis. Necrotizing pancreatitis develops in about 15% of patients with pancreatitis and accounts for mortality ranging from 12 to 35%. The traditional approach to the treatment of necrotizing pancreatitis with secondary infection of necrotic tissue is open necrosectomy to completely remove the infected necrotic tissue.

Original languageEnglish (US)
Title of host publicationSurgical Critical Care and Emergency Surgery
Subtitle of host publicationClinical Questions and Answers: Second Edition
PublisherWiley-Blackwell
Pages385-392
Number of pages8
ISBN (Electronic)9781119317913
ISBN (Print)9781119317920
DOIs
StatePublished - Apr 3 2018
Externally publishedYes

Keywords

  • Bile duct injuries
  • CT scan
  • Index cholecystectomy
  • Laparotomy
  • Open necrosectomy
  • Pancreatic injuries

ASJC Scopus subject areas

  • Medicine(all)

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