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February 1983

Surgery of the Gallbladder and Bile Ducts

Arch Surg. 1983;118(2):253. doi:10.1001/archsurg.1983.01390020095016

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Lord Smith and Professor Sherlock have assembled a distinguished team of 20 mainly British contributors to this account of current biliary surgical practice. It starts with a beautifully illustrated chapter on the ultrastructure of the biliary tract by Toner and Carr and a clear one on physiology by Bouchier. Sherlock deals with the treatment of jaundice, and Lord Smith discusses injuries of the bile ducts and carcinoma of the gallbladder and common hepatic duct.

A multiauthor approach has disadvantages, and some sections provide conflicting advice. Kreel and Dick, in discussing interventional radiology, advocate external drainage "for all patients in whom a cholangiogram reveals partially or completely obstructed bile ducts... It undoubtedly has minimal morbidity compared to aggressive biliary tract surgery, the only complication being local pain and leakage of bile in a small percentage of patients." This radiologic enthusiasm will not be shared by experienced surgeons, who may feel happier

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