My lessons

An educational program developed by the Institute of Image-Guided Surgery of Strasbourg, University of Strasbourg and in partnership with IRCAD.

1.
Biliary tract
2.
EUS
3.
Imaging
4.
Webinar replay
1.
Biliary tract
2.
EUS
3.
Imaging
4.
Webinar replay

Hepato-Biliary-Pancreatic


Module Three is a continuation of our organ system - focused approach to flexible surgical endoscopy. In this module, “Hepatobiliary-Pancreatic” (HBP), we cover the pertinent anatomy, physiology, disease processes and interventions pertaining to the medical and surgical management of this complex system...

Introduction


Presentation

Module Three is a continuation of our organ system – focused approach to flexible surgical endoscopy. In this module, “Hepatobiliary-Pancreatic” (HBP), we cover the pertinent anatomy, physiology, disease processes and interventions pertaining to the medical and surgical management of this complex system.

We detail the pre- and post-op anatomy of the liver, pancreas and biliary tree, covering specific terminology for liver segmentation and pedicle anatomy. We explore the use of EUS, ERCP, choledocoscopy, cholangiography and non-invasive imaging methods for the examination of HPB anomalies and pathology. We cover the evaluation and management of malignant processes such as intra-hepatic, peri-ampullary, pancreatic and biliary-derived tumors as well as benign processes such as ductal stones, variations in anatomy (papillary, ductal or biliary tract), fistulas and strictures. Special attention will be paid to the variety of pancreatic tumors (mucinous, adenocarcinoma and endocrine) and the nuances to their appropriate diagnosis and management.

From this foundation we learn about the surgical and endoscopic techniques available for intervention. We cover endovascular and percutaneous approaches to liver tumors; the basics of hepatic resection and surgical treatment for biliary or gallbladder disease; lithotripsy and extraction of ductal stones; ERCP, biliary drainage, stenting, tissue ablation and dilatation; and pancreatic enucleation versus segmental resection or necrosectomy.

Finally, we discuss the common complications of these procedures, both immediate and long term, in regard to frequency, recognition and management.

9 lessons

6 speakers

10:05 hours

87 followers

Course directors


Patrick Pessaux

G. Donatelli

Gianfranco Donatelli

G. COSTAMAGNA

Guido Costamagna

Objectives

  • Understand normal and common post-operative anatomy of the HPB system.
  • Understand the terminology of liver segmentation and the liver pedicle.
  • Understand the diagnostic and management principles of:
    • Malignant processes such as intra-hepatic, peri-ampullary, pancreatic and biliary-derived tumors as well as
    • Benign processes such as ductal stones, variations in anatomy (papillary, ductal or biliary tract), fistulas and strictures.
  • Possess a basic understanding of the variety of pancreatic tumors and differences in diagnosis and management
  • Understand the use of various imaging modalities for evaluation of HPB pathology, including:
    • EUS
    • ERCP
    • Choledochoscopy
    • Cholangiography
    • CT scan
    • MRI
  • Understand the contraindications, indications and basic techniques of surgical and endoscopic HPB interventions such as:
    • ERCP
    • Tissue ablation
    • Percutaneous catheterization
    • Stenting
    • Balloon dilatation
    • Biliary drainage
    • Liver resection
    • Pancreatic resection (segmental vs. enucleation)
  • Understand how to recognize and manage common complications from HPB interventions such as fistulas, structures, leaks and bleeding.

Biliary tract


Minimal access cholecystectomy

Laparoscopic cholecystectomy has been described almost thirty years ago. The technique has been refined over the years, but the risks of injury to the bile duct remain higher than the rates that had been identified in open surgery.

25 min Bernard Dallemagne

Bile duct injury during laparoscopic cholecystectomy?

Laparoscopic cholecystectomy has been described almost thirty years ago. The technique has been refined over the years, but the risk of injury to the bile duct remains higher than the rates that had been identified in open surgery.

42 min Bernard Dallemagne

Laparoscopic pancreatic surgery

More than twenty years after its original description, laparoscopic pancreatic surgery is now a validated approach that has shown significant advantages over traditional surgery.

54 min Bernard Dallemagne

ERCP for dummies, where to start ?

This lecture describes the basic of ERCP providing tips and tricks to succeed cannulation of the CBD and biliary sphincterotomy.

20 min Guido Costamagna

EUS


Imaging


Webinar replay


Webinar replay

Replay of webinar held on March 8, 2022

ERCP relevant anatomy Ivo Boškoski

Evaluation of the papilla and positioning; Scope maneuvering and use of the elevator; Cannulation; Difficult anatomy Theodor Voiosu     
 

61 min