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Diseases of the biliary tract represent some of the most challenging problems for the surgeon. Gallstone disease is a common ailment, for which surgical treatment has been recorded since ancient times. In the following chapters, authorities in the field will describe the often-performed procedures of cholecystectomy and common bile duct exploration. Versions of these procedures performed as open surgery will be presented, as well as the laparoscopic versions, which arguably represent one of the major advances in general surgery in the past two decades. Surgery to fix bile duct injury, the most feared complication from treatment of gallstone disease, will also be presented.

Next come discussions of treatments for diseases that are much rarer: congenital malformations of the biliary tree and malignancies of the proximal/mid bile duct and gallbladder. Resections of these conditions are extremely challenging from a technical perspective. The principles, operative conduct, and “tricks of the senior surgeon” are presented by accepted masters of this trade. Distal bile duct problems are presented in the chapters on pancreatic resection. Finally, palliative bypasses for obstructions of the biliary tree are presented. These chapters describe the general approach to performing a facile biliary-enteric anastomosis, as well as methods of specific bypass procedures such as a choledochoduodenostomy or a hepaticojejunostomy. Even though biliary stent placement by endoscopic or percutaneous routes is widely used for patients who have clearly unresectable malignancies, for patients with benign disease or with disease found unresectable at surgery, such bypasses offer durable palliation with little added morbidity over the surgical exploration.