| Theme |
Laparoscopic Treatment of Gastroenterological Diseases in Terms of Their Indication and Limitation |
| Title |
Laparoscopic Surgery for Biliary Tract |
| Author |
Michinori Murayama |
Department of Surgery, Japan Self Defense Force Hanshin Hospital |
| Author |
Tsukasa Aihara |
Department of Surgery, Japan Self Defense Force Hanshin Hospital |
| Author |
Toshihiko Yagyu |
Department of Surgery, Japan Self Defense Force Hanshin Hospital |
| Author |
Eishu Nakamura |
Department of Surgery, Japan Self Defense Force Hanshin Hospital |
| Author |
Minoru Kakihara |
First Department of Surgery, National Defense Medical College |
| Author |
Kazuo Hatsuse |
First Department of Surgery, National Defense Medical College |
| [ Summary ] |
The proportion of cholecystectomies done laparoscopically has risen to 85% in Japan. The introduction of laparoscopic cholecystectomies induced a significant rise in cholecystectomy rates. Acute cholecystitis, gall bladder polyps and early gall bladder cancer are treated laparoscopically with careful consideration of the timing and technical modifications. Conversion to open surgery and postoperative complications were observed with some frequency. Bile duct injury should be avoided most carefully. Routine intraoperative cholangiography and placement of intra-abdominal drainage are still controversial. A training system was established to avoid complications due to the early learning curve. There are diverse indications and procedures for laparoscopic common bile duct exploration. Although endoscopic treatment for choledo cholithiasis is popular, laparoscopic treatment is a more beneficial and economical strateg. It is hoped that laparoscopic common bile duct exploration will become a more common surgery. |