Pierre-Alain Clavien, MD, PhD, FACS, FRCS

436 Pages·2008·11.25 MB·English

Diseases of
theGallbladder
and BileDucts
To our mentors, to whom we are profoundly indebted for their inspired
teaching, long-standing support, and advice during our careers
(PAC): Felix Harder, Adrien Rohner, Martin Allgöwer Bernie Langer,
Steve Strasberg and David Sabiston
(JB): Jack Vennes, Steve Silvis, Peter Cotton and Dick Kozarek
The Editors and Publisher have made every effort to contact all copyright
holders to obtain their permission to reproduce copyright material. How-
ever, if any have been inadvertently overlooked, the Publisher will be
pleased to make the necessary arrangements at the first opportunity.
Diseases of the
Gallbladder and
Bile Ducts
Diagnosis and Treatment
EDITED BY
Pierre-Alain Clavien,
MD, PhD, FACS, FRCS
Professor and Chairman
Swiss Hepato-Pancreato-Biliary Center
Department of Visceral and Transplant Surgery
University Hospital Zurich
Zurich, Switzerland
John Baillie,
MB, ChB, FRCP, FACG
Professor of Medicine
Director of Hepatobiliary and Pancreatic Disorder Service
Wake Forest University Health Sciences Center
Winston-Salem, North Carolina, USA
ASSOCIATE EDITORS
Michael A.Morse, MD
Duke UniversityMedical Center
Markus Selzner, MD
University Hospital Zurich
SECOND EDITION
© 2006 by Blackwell Publishing Ltd
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First published 2001
Second edition 2006
1 2006
Library of Congress Cataloging-in-Publication Data
Diseasesofthegallbladder and bile ducts : diagnosis and treatment /
editedbyPierre-Alain Clavien, John Baillie ; associate editors,
Michael A. Morse, Markus Selzner.– 2nd ed.
p. ; cm.
Includes bibliographical referencesand index.
ISBN-13: 978-1-4051-2740-0
ISBN-10: 1-4051-2740-6
1. Gallbladder–Diseases. 2. Bile ducts–Diseases. I. Clavien, Pierre-
Alain. II. Baillie, John, FRCP (Glasg.)
[DNLM: 1. Gallbladder Diseases–diagnosis. 2. Bile Duct Diseases –
diagnosis. 3. Bile Duct Diseases–therapy. 4. Gallbladder Diseases –therapy.
WI 750 D611 2006]
RC845.C55 2006
616.3′65–dc22
2006000956
ISBN-13: 978-1-4051-2740-0
ISBN-10:1-4051-2740-6
A catalogue record for this title is available from the British Library
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book.
Contents
Contributors, vii
Preface, ix
Abbreviations, xi
Section 1. Anatomy, pathophysiology, and epidemiology of the biliary system
1. Anatomy and physiology of the biliary tree and gallbladder, 3
James Toouli and Mayank Bhandari
2. Pathology of the intrahepatic and extrahepatic bile ducts and gallbladder, 21
Kay Washington
3. Epidemiology of diseases of the bile ducts and gallbladder, 58
Markus H. Heim
Section 2. Diagnostic and therapeutic approachesfor the biliary tree and gallbladder
4. Noninvasive imaging of the biliary system, 71
Elmar M. Merkle, Rendon C. Nelson and Henrik Petrowsky
5. Endoscopic diagnosis and treatment of disorders of the biliary tree and gallbladder, 97
Kevin McGrath and John Baillie
6. Percutaneous biliary imaging and intervention, 120
Paul V. Suhocki
7. Radiation therapy for disease of the biliary tree and gallbladder, 147
Brian G. Czito and MitchellS. Anscher
8. Surgery ofthe biliary system, 163
Lucas McCormack,Markus Selzner and Pierre-Alain Clavien
9. Laparoscopic treatment for diseases of the gallbladder and biliary tree, 174
Stefan Wildi, Sarah K. Thompson, John G. Hunter and Markus Weber
10. Laparoscopic biliary injuries, 182
Steven M. Strasberg
11. Medical and innovative therapies for biliary malignancies, 205
Michael A. Morse and Bernhard Pestalozzi
Section 3. Specific conditions
Section 3.1. The gallbladder
12. Natural history and pathogenesis of gallstones, 219
Beat Müllhaupt
v
vi Contents
13. Acute and chronic cholecystitis, 229
Stefan Breitenstein, Armin Kraus and Pierre-Alain Clavien
14. Biliary fistula, gallstone ileus, and Mirizzi’s syndrome, 239
Henrik Petrowsky and Pierre-Alain Clavien
15. Benign and malignant gallbladder tumors, 252
John T. Mullen, Christopher H. Crane and Jean-Nicolas Vauthey
Section 3.2. The intrahepaticand extrahepaticbile ducts
16. Acute cholangitis, 265
Suyi Chang and Joseph Leung
17. Cystic diseases of the biliary system, 277
Robert J. Porte and Pierre-Alain Clavien
18. Biliary complications of liver transplantation, 289
Mary T. Austin and C. Wright Pinson
19. Primary sclerosingcholangitis, 306
Robert Enns
20. Cholangiocarcinoma, 332
Markus Selzner and Pierre-Alain Clavien
21. Primary biliary cirrhosis, 341
Piotr Milkiewicz and Jenny Heathcote
Section 3.3. Intrahepaticcholestasis
22. Intrahepatic cholestasis, 355
Andrew Stolz and Neil Kaplowitz
Section 3.4. Pediatric population
23. Biliary disease in infants and children, 377
Riccardo Superina
Answers, 411
Index, 415
Color plate section appears after page 84
Contributors
Mitchell S. Anscher, MD Robert Enns, MD, FRCP
Department of Radiation Oncology Division of Gastroenterology
Duke UniversityMedical Center Department of Medicine
Durham, North Carolina, USA St. Paul’sHospital
University of British Columbia
Mary T. Austin, MD, MPH Vancouver, British Columbia, Canada
Department of Surgery
Jenny Heathcote,MD, FRCP, FRCP
Division of Hepatobiliary Surgery and Liver Transplantation
Vanderbilt University Medical Center University of Toronto
Nashville, Tennessee, USA Toronto Western Hospital
Toronto, Ontario, Canada
John Baillie, MB, ChB,FRCP, FACG
Markus H. Heim, MD
Professor of Medicine
Division of Gastroenterology and Hepatology
Director of Hepatobiliary and Pancreatic Disorder Service
University Hospital Basel
Wake Forest University Health Sciences Center
Basel, Switzerland
Winston-Salem, North Carolina, USA
John G. Hunter, MD
Mayank Bhandari, MBBS, MS
Department of Surgery
Department of General and Digestive Surgery Oregon Health and Science University
Flinders Medical Centre Portland, Oregon, USA
Flinders University
Bedford Park, Adelaide, SA, Australia Neil Kaplowitz, MD
USC Research Centerfor Liver Diseases
Stefan Breitenstein, MD Division of Gastrointestinal and Liver Diseases
Swiss Hepato-Pancreato-Biliary Center Keck School of Medicine
Department of Visceral and Transplantation Surgery University of Southern California
University Hospital Zurich Los Angeles, California, USA
Zurich, Switzerland
Armin Kraus, MD
Suyi Chang, MD, PhD Swiss Hepato-Pancreato-Biliary Center
Division of Gastroenterology Department of Visceral and Transplant Surgery
Davis Medical Center University Hospital Zurich
University of California Zurich, Switzerland
Davis, California, USA
Joseph Leung, MD, FRCP, FACP, FACG
Davis School of Medicine
Pierre-Alain Clavien,MD, PhD, FACS, FRCS
University of California
Swiss Hepato-Pancreato-Biliary Center
Section of Gastroenterology
Department of Visceral and Transplant Surgery
VA Northern California HealthCare System
University Hospital Zurich
Sacramento, California, USA
Zurich, Switzerland
Lucas McCormack, MD
Christopher H. Crane, MD
Swiss Hepato-Pancreato-Biliary Center
Department of Radiation Oncology Department of Visceral and Transplant Surgery
University of Texas University Hospital Zurich
M. D. Anderson Cancer Center Zurich, Switzerland
Houston, Texas, USA
Kevin McGrath, MD
Brian G. Czito, MD Division of Gastroenterology
Department of Radiation Oncology Department of Medicine
Duke UniversityMedical Center Duke UniversityMedical Center
Durham, North Carolina, USA Durham, North Carolina, USA
vii
viii Contributors
Elmar M. Merkle, MD Andrew Stolz, MD
Department of Radiology USC Research Centerfor Liver Diseases
Duke UniversityMedical Center Division of Gastrointestinal and Liver Diseases
Durham, North Carolina, USA Keck School of Medicine
University of Southern California
Piotr Milkiewicz, MD, MRCP Los Angeles, California, USA
University of Toronto
Toronto Western Hospital Steven M. Strasberg, MD
Toronto, Ontario, Canada Section of HPB/GI Surgery
and Department of Gastroenterology Washington University in Saint Louis
Pomeranian Medical School Saint Louis, Missouri, USA
Szczecin, Poland
Paul V. Suhocki, MD
Michael A. Morse, MD
Division of Interventional Radiology
Division of Medical Oncology
Department of Radiology
Duke UniversityMedical Center
Duke UniversityMedical Center
Durham, North Carolina, USA
Durham, North Carolina, USA
John T. Mullen, MD
Riccardo Superina, MD
Department of Surgical Oncology
Feinberg Schoolof Medicine
University of Texas
Northwestern University
M. D. Anderson Cancer Center
Chief of Pediatric Transplant Surgery
Houston, Texas, USA
Children’s Memorial Hospital
Chicago,Illinois, USA
Beat Müllhaupt, MD
Swiss Hepato-Pancreato-Biliary Center
Sarah K. Thompson, MD
Division of Gastroenterology and Hepatology
University Hospital Zurich Department of Surgery
Zurich, Switzerland Oregon Health and Science University
Portland, Oregon, USA
Rendon C. Nelson, MD
Department of Radiology James Toouli, MBBS, B(Med)Sci, PhD, FRACS
Duke UniversityMedical Center Department of General and Digestive Surgery
Durham, North Carolina, USA Flinders Medical Centre
Flinders University
Bernhard Pestalozzi, MD Bedford Park, Adelaide, SA, Australia
Swiss Hepato-Pancreato-Biliary Center
Department of Oncology Jean-Nicolas Vauthey, MD, FACS
University Hospital Zurich Department of Surgical Oncology
Zurich, Switzerland University of Texas
M. D. Anderson Cancer Center
Henrik Petrowsky, MD Houston, Texas, USA
Swiss Hepato-Pancreato-Biliary Center
Department of Visceral and Transplant Surgery Kay Washington, MD, PhD
University Hospital Zurich
Department of Pathology
Zurich, Switzerland
Vanderbilt University Medical Center
Nashville, Tennessee, USA
C. Wright Pinson, MD, MBA
Department of Surgery
Markus Weber, MD
Division of Hepatobiliary Surgery and Liver Transplantation
Swiss Hepato-Pancreato-Biliary Center
Vanderbilt University Medical Center
Department of Visceral and Transplant Surgery
Nashville, Tennessee, USA
University Hospital Zurich
Zurich, Switzerland
Robert J. Porte, MD, PhD
Department of Surgery
Stefan Wildi, MD
Division of Hepatobiliary Surgery and Liver Transplantation
University Medical Center Groningen Swiss Hepato-Pancreato-Biliary Center
Groningen, The Netherlands Department of Visceral and Transplant Surgery
University Hospital Zurich
Markus Selzner, MD Zurich, Switzerland
Swiss Hepato-Pancreato-Biliary Center
Department of Visceral and Transplant Surgery
University Hospital Zurich
Zurich, Switzerland
Preface
Diseasesofthe gallbladder and bile ducts are common and added two new chapters, one on “Epidemiology of diseases of
major focuses in gastroenterology, oncology, radiology, nu- the bile duct and gallbladder”by Dr Markus Heim from Basel
clear medicine, and surgery. These past two decades have (Chapter 3), and one on “Noninvasive imaging of the biliary
brought numerous new diagnostic and therapeutic modali- system” by Drs Elmar Merkle and Rendon C. Nelson from
ties ranging from mini-invasive proceduressuch as complex Duke University and Dr HenrikPetrowsky fromthe Univer-
endoscopic or laparoscopic procedures to new techniques of sity Hospital Zurich. A number of new authors have been in-
liver transplantation. Major advances have also been made in vited based on their expertise and excellence in science
the understanding of the pathogenesis of a variety of condi- writing. Finally, to enhance the didactic aspect of the book
tions and the natural history of previously unclear entities. wehaveincluded objectives at the beginning of each chapter
While this has led to better “evidence-based” treatments of and, at the end, a series of key questions covering the main
patients, the proliferation of new diagnostic and therapeutic message of each respective chapter.
tools has also led to confusion about which therapy to select This second edition is designed to serve the needs of all
for particular situations. The modern treatment of biliary those involved in the management of patients with biliary
diseases must be approached through a multidisciplinary diseases from medical students tospecialists in various areas.
team having special knowledge in this field. In addition, a The first series of three chapters comprehensively covers
number of innovative approaches are still experimental and anatomy, physiology and pathology, and imaging modalities
often technically demanding, so that complex biliary prob- of the biliary tree. The next eight chapters present various
lems should be managed in centers with experience in treat- therapeutic approaches involving medical, endoscopic, and
ing these patients and a strong commitment to research. percutaneous treatments, as well as open and laparoscopic
To this end, the first edition of Diseases of the Gallbladder and surgery. Then, four chapters are dedicated to the gallbladder
Bile Ducts: Diagnosis and Treatmentpublished in 2001 has pro- followed by six chapters about a variety of common diseases,
vided a comprehensive and critical approach to established such as acute cholangitis, and less common intra- and extra-
and new diagnostic and therapeutic modalities. The book hepatic biliary diseases. Finally, a chapter is dedicated to the
was written by a multidisciplinary panel of international ex- complex problem of intrahepatic cholestasis, and the last
perts with extensive experience in this population of pa- chapter covers specific biliary disorders in the pediatric
tients. Due to rapid developments in this field, we felt it was population (Chapter 23).
necessary to prepare a second edition. This new edition was We hope thatthis new edition of Diseases of the Gallbladder
done with the same spirit and format. To further secure qual- and Bile Ducts: Diagnosis and Treatmentwill provide timely in-
ity, to achieve the comprehensive and balanced coverage of formation and guidelines for the management of this popula-
each topic, to avoid redundancy among chapters, and to pro- tion of patients.
vide appropriate cross-references, we included two Associate
Editors, Dr Michael A. Morse from Duke University and Dr P.-A.C.
Markus Selzner from the University Hospital Zurich. We also J.B.
ix