| [NT 15003449]: |
Historical Perspective on the Treatment of Choledocholithiasis: Lessons Learned and Techniques Prior to the Laparoscopic Era -- Current Understanding of Choledocholithiasis- Clinical Presentation and Pre-operative Evaluation -- Preoperative Decision-making Algorithm -- Intraoperative Ultrasound- Technique, Results, Pearls/Pitfalls, Rationale, and Benefits of Routine Use -- Intraoperative Cholangiography- Technique, Results, Pearls/Pitfalls, Rationale, and Benefits of Routine Use -- Laparoscopic Trans-cystic Exploration (Deciding who to Approach, Contraindications, Techniques- Cannulation, Dilation, Flouro-guided v. Choledochoscopy, Results, Complications, and Their Management -- Laparoscopic transcholedochal exploration (deciding who to approach, contraindications, technique of choledochotomy, instruments - catheters, scopes, etc., closure - primary v. t-tube v. internal drainage, results, complications and their management)- Stone fragmentation technologies and the approach to impacted stones (laser, mechanical lithotripsy, shock-wave, pneumatic and ultrasonic lithotriptors)- Adjuncts to common bile duct exploration (stents, drains, balloon dilation, antegrade sphincterotomy)- Open Common Bile Duct Exploration (indications/role in the modern era, technique, outcomes/complications)- Role of bilioenteric bypass in management of biliary stone disease (how to decide who needs this, technique, results/complications and management)- Endoscopic sphincterotomy for choledocholithiasis - preoperative v. postoperative, techniques, stone fragmentation for large stones, complications and management, outcomes, recent issues of infection with multi-drug resistant bacteria and implications)- Endoscopic ultrasound (EUS)- role in diagnosis and management of choledocholithiasis, transhepatic EUS approaches -- Laparoscopic-assisted ERCP (rendezvous procedures and transgastric ERCP) -- Percutaneous techniques (transhepatic drainage) -- Overcoming Institutional and Logistical Barriers to LCBDE. |