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Article
April 1994

Diogenes in the Biliary Tract

Author Affiliations

Los Angeles, Calif

Arch Surg. 1994;129(4):343-344. doi:10.1001/archsurg.1994.01420280009001

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Abstract

The Greek philosopher Diogenes (412 to 323 BC) founded the Cynic school of philosophy. Among his many ascetic practices, the one most popularly associated with him is the image of his endless search, lantern held aloft, for a man of truth. Why should this conjure up the image of a miniature counterpart of Diogenes, roaming the biliary tract, searching for the truth? Because the laparoscopic revolution has spawned a number of unresolved questions, not the least of which are centered on the biliary tract.

First, there is the question of bile duct injury. The current literature is replete with reports of large numbers of laparoscopic cholecystectomies without a single instance of common bile duct injury.1,2 Yet, reports continue to surface from major medical centers of an unusually high number of secondary referrals for repair of ductal injuries.3-5 What then is the true incidence of common bile duct injury?

References
1.
Baird DR, Wilson JP, Mason EM, et al.  An early review of 800 laparoscopic cholecystectomies at a university-affiliated community teaching hospital . Am Surg . 1992:58:206-210.
2.
Super NJ, Dunnegan DL.  Laparoscopic cholecystectomy: experience of a single surgeon . World J Surg . 1993;17:16-21.Article
3.
Adams DB, Borowicz MR, Wootton FT III, Cunningham JT.  Bile duct complications after laparoscopic cholecystectomy . Surg Endosc . 1993: 7:79-83.Article
4.
Cates JA, Tompkins RK, Zinner MJ, Busuttil RW, Kallman C, Rosllyn JJ.  Biliary complications of laparoscopic cholecystectomy . Am Surg . 1993; 59:243-247.
5.
RessAM, Sarr MG, Nagorney DM, Farnell MB, Donohue JH, Mcllrath DC.  Spectrum and management of major complications of laparoscopic cholecystectomy . Am J Surg . 1993;165:655-662.Article
6.
Flowers JL, Zucker KA, Graham SM, Scovill WA, Imbembo AL, Bailey RW.  Laparoscopic cholangiography: results and indications . Ann Surg . 1992;215:209-216.Article
7.
Bruhn EW, Miller FJ, Hunter JG.  Routine fluoroscopic cholangiography during laparoscopic cholecystectomy: an argument . Surg Endosc . 1991;5:111-115.Article
8.
Gerber A, Apt MK.  The case against routine operative cholangiography . Am J Surg . 1982:143: 734-736.Article
9.
Pace BW, Cosgrove J, Breuer B, Margolis IB.  Intraoperative cholangiography revisited . Arch Surg . 1992;127:448-450.Article
10.
Brodish RJ, Fink AS.  ERCP, cholangiography, and laparoscopic cholecystectomy . Surg Endosc . 1993;7:3-8.Article
11.
Cotton PB, Lehman G, Vennes J, et al.  Endoscopic sphincterotomy complications and their management: an attempt at consensus . Gastrointest Endosc . 1991;37:383-393.Article
12.
Stoker ME, Vose J, O'Mara P, Maini BS.  Laparoscopic cholecystectomy: a clinical and financial analysis of 280 operations . Arch Surg . 1992; 127:589-595.Article
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