PubMed · 2353110
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
D Picus. 1990. Percutaneous gallbladder intervention.. https://doi.org/10.1148/radiology.176.1.2353110
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
Since Stalpert von der Wiel first incised the abdominal wall for bile drainage in a patient with an intraabdominal abscess due to gangrenous cholecystitis with calculi in 1684, the problems inherent in the treatment of cholelithisiasis have received attention from surgeons working in this field. However, the major event was the development of the technique of cholecystectomy by Langenbuch in 1882 opening a new era in surgery for cholelithiasis. Subsequently numerous advances were made in cholecystectomy, choledochotomy, choledochoenterostomy, and sphincteroplasty associated with progress in the diagnostic techniques and instrumentation necessary to perform surgery for cholelithiasis. However, the outcomes of these methods were criticized, and they were gradually abandoned due to development of minimally invasive endoscopic or laparoscopic surgery. The development of laparoscopic cholecystectomy revolutionized the history of biliary surgery. In the 21st century, the best treatment will be available to all patients with the use of ultramodern technologies such as telesurgery and robotic surgery.
Laparoscopic surgery of the pancreas remains, other than for certain clear indications, primarily investigational. However, in the past few years, laparoscopic therapy for pancreatic diseases has made significant strides and will undoubtedly contribute increasingly to the care of the surgical patient with pancreatic disease. This review discusses the current status of minimally invasive surgical therapy of pancreatic diseases and reviews the current literature. There are four major areas of clinical and laboratory investigation, including diagnostic laparoscopy for staging of pancreatic cancer, laparoscopic palliation of unresectable pancreatic cancer, laparoscopic management of pancreatic pseudocyst, and laparoscopic partial pancreatectomy (pancreaticoduodenectomy, distal pancreatectomy, and enucleation for islet cell tumors). The increased sensitivity of staging laparoscopy with laparoscopic ultrasound as a staging modality in the diagnosis of previously unrecognized metastatic disease from pancreatic cancer is clearly the most utilitarian application of laparoscopic technology in this patient population. Additionally, a natural extension of staging laparoscopy with laparoscopic ultrasound is the ability to improve the quality of life for the patient with unresectable pancreatic cancer by palliating the biliary and gastrointestinal obstruction and the debilitating pain, without the need for and morbidity of open laparotomy. Laparoscopic internal drainage of pancreatic pseudocysts remains early in its development but appears to have potential benefit from application of minimal access techniques. And laparoscopic partial pancreatectomy, both pancreaticoduodenectomy, and, to a lesser degree, distal pancreatectomy, remain primarily investigational without clearly established benefits from the use of minimal access techniques.
Explore the source record for details and available documents.