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Epidemiology and prevention of gallstone disease
2036
BOOK REVIEWS
on diagnosis and management of cholelithiasis and choledocholithiasis are probably no less state of the art, but concepts are offered as gospel and no important questions are raised, which suggests a need for prospective data gathering. Among this latter group, there is a thoughtful chapter on choledocholithiasis. For those who read this and respond by saying “Hey, wait a minute” and then remark that very little is known about the formation and composition of choledocholithiasis, much less its natural history, I also recommend several references cited in this chapter, including the author’s. Pigment stones are treated by authors who have been intensely interested in their pathogenesis. Dietary factors in the genesis and management of gallstones and carcinoma of the gallbladder are appropriately put into perspective. Gastroenterologists and surgeons who deal with the alimentary tract should have this book. You are bound to find a chapter for your appetite; of course it is worth the money. MALCOLM P. TYOR, M.D.
Durham, North Carolina
Epidemiology and Prevention of Gallstone Disease. Edited by L. Capocaccia, G. Ricci, F. Angelico, M. Angelico, and A. F. Attili. 240 pp., $47.75. MTP Press Limited (distributed in U.S. by Kluwer Academic Publishers, Hingham, Massachusetts], 1984. Perhaps the most interesting and important aspect of research in biliary tract stone disease today is pathogenesis. Increasingly effective methods for gallstone dissolution enhance the relevance of developing practical methods for stone prevention. An international workshop on the epidemiology and prevention of gallstone disease was held in Rome in December 1983. Twenty-nine investigators from five countries contributed data from recent or ongoing studies to review what is known and what needs further study. This well-edited proceedings is divided into sections on epidemiology, metabolic aspects of gallstone disease, lessons for clinical practice, and the present status of the prevention of gallstones. The text is easy and enjoyable to read. Most chapters are concise but have sufficient content to provide an overview. Some chapters are detailed, e.g., one chapter on gallbladder cancer contains 101 references, whereas others are more superficial. Most sections are well-referenced. Data from epidemiologic studies among several populations are provided. The review of the metabolic factors in the pathogenesis of cholesterol gallstones is excellent. The evidence in support of dietary factors in the etiology of gallstones is discussed by several investigators. Studies on the relationships among serum lipids, coronary heart disease, obesity, and gallstones are approached by several groups. Most available data relevant to gallstone epidemiology are addressed. The number of clinically important questions that remain unanswered in regard to the epidemiology and prevention of gallstones is impressive. This text reflects the proper perception that a great deal needs to be learned about this subject. These proceedings should provide an
GASTROENTEROLOGY Vol. 90, No. 6
excellent stimulus to anyone planning or participating in studies on any aspect of gallstone epidemiology or prevention. JOHNSON L. THISTLE, M.D.
Rochester, Minnesota
Common Bile Duct Exploration (Intraoperative Investigations in Biliary Tract Surgery). By A. Cuschieri and G. Cerci. 100 pp., 97 figures, $76.50. Martinus Nijhoff Publishers (distributed in U.S. by Kluwer Academic Publishers, Hingham, Massachusetts), 1984. The technique of common duct exploration is well established; consequently, why should anyone write a new book exclusively devoted to this subject? The reasons appear to be the authors’ desires to stress the utilization of two techniques: one prior to and one during such an exploration. These are intraoperative cholangiography and cholangioscopy. Based largely upon a l-week collaborative venture between surgeons and medical photographers, this volume is intended to serve as a documentary atlas of operative experience in selected patients with biliary tract disease. The volume also serves as a guide for technique and decision making. Additional material was obtained from one of the author’s experience in Los Angeles. Illustrations are the most prominent feature. Many are in color and show the operations and endoscopic views of the bile ducts; these illustrations probably account for the high cost of this book. The authors emphasize intraoperative cholangiography and the use of the rigid endoscope in cholangioscopy. There is almost no description of cholangioscopy with flexible endoscopes. They champion the merits of fluorocholangiography using permanently mounted x-ray equipment in the operating room. Biliary manometry is also discussed. A chapter on the postoperative remova! of retained stones through the T-tube tract is included, but there is no significant mention of performing such an extraction via upper gastrointestinal endoscopy. In summary, this monograph presents the authors’ approach to surgery of the common duct for stones based on their own experience and is not a full account of the subject. Many of the illustrations are excellent and constitute the main merit of this work. BERNARD SIGEL, M.D.
Philadelphia, Pennsylvania
In Vitro Models for Cancer Research. Volume 1. Carcinomas of the Esophagus and Colon. Edited by M. W. Webber and L. I. Sekely. 239 pp., 69 figures, $77.00. CRC Press, Boca Raton, Florida, 1985. An introduction by Webber, a foreword by W. R. Waddell, and a preface by Webber and Sekely all extolling the potential and the contributions of in vitro experimentation in elucidating the etiopathogenesis of esophageal and colonic cancer open this volume, which is divided into an “Esophagus” and a “Colon” section.
BOOK REVIEWS
on diagnosis and management of cholelithiasis and choledocholithiasis are probably no less state of the art, but concepts are offered as gospel and no important questions are raised, which suggests a need for prospective data gathering. Among this latter group, there is a thoughtful chapter on choledocholithiasis. For those who read this and respond by saying “Hey, wait a minute” and then remark that very little is known about the formation and composition of choledocholithiasis, much less its natural history, I also recommend several references cited in this chapter, including the author’s. Pigment stones are treated by authors who have been intensely interested in their pathogenesis. Dietary factors in the genesis and management of gallstones and carcinoma of the gallbladder are appropriately put into perspective. Gastroenterologists and surgeons who deal with the alimentary tract should have this book. You are bound to find a chapter for your appetite; of course it is worth the money. MALCOLM P. TYOR, M.D.
Durham, North Carolina
Epidemiology and Prevention of Gallstone Disease. Edited by L. Capocaccia, G. Ricci, F. Angelico, M. Angelico, and A. F. Attili. 240 pp., $47.75. MTP Press Limited (distributed in U.S. by Kluwer Academic Publishers, Hingham, Massachusetts], 1984. Perhaps the most interesting and important aspect of research in biliary tract stone disease today is pathogenesis. Increasingly effective methods for gallstone dissolution enhance the relevance of developing practical methods for stone prevention. An international workshop on the epidemiology and prevention of gallstone disease was held in Rome in December 1983. Twenty-nine investigators from five countries contributed data from recent or ongoing studies to review what is known and what needs further study. This well-edited proceedings is divided into sections on epidemiology, metabolic aspects of gallstone disease, lessons for clinical practice, and the present status of the prevention of gallstones. The text is easy and enjoyable to read. Most chapters are concise but have sufficient content to provide an overview. Some chapters are detailed, e.g., one chapter on gallbladder cancer contains 101 references, whereas others are more superficial. Most sections are well-referenced. Data from epidemiologic studies among several populations are provided. The review of the metabolic factors in the pathogenesis of cholesterol gallstones is excellent. The evidence in support of dietary factors in the etiology of gallstones is discussed by several investigators. Studies on the relationships among serum lipids, coronary heart disease, obesity, and gallstones are approached by several groups. Most available data relevant to gallstone epidemiology are addressed. The number of clinically important questions that remain unanswered in regard to the epidemiology and prevention of gallstones is impressive. This text reflects the proper perception that a great deal needs to be learned about this subject. These proceedings should provide an
GASTROENTEROLOGY Vol. 90, No. 6
excellent stimulus to anyone planning or participating in studies on any aspect of gallstone epidemiology or prevention. JOHNSON L. THISTLE, M.D.
Rochester, Minnesota
Common Bile Duct Exploration (Intraoperative Investigations in Biliary Tract Surgery). By A. Cuschieri and G. Cerci. 100 pp., 97 figures, $76.50. Martinus Nijhoff Publishers (distributed in U.S. by Kluwer Academic Publishers, Hingham, Massachusetts), 1984. The technique of common duct exploration is well established; consequently, why should anyone write a new book exclusively devoted to this subject? The reasons appear to be the authors’ desires to stress the utilization of two techniques: one prior to and one during such an exploration. These are intraoperative cholangiography and cholangioscopy. Based largely upon a l-week collaborative venture between surgeons and medical photographers, this volume is intended to serve as a documentary atlas of operative experience in selected patients with biliary tract disease. The volume also serves as a guide for technique and decision making. Additional material was obtained from one of the author’s experience in Los Angeles. Illustrations are the most prominent feature. Many are in color and show the operations and endoscopic views of the bile ducts; these illustrations probably account for the high cost of this book. The authors emphasize intraoperative cholangiography and the use of the rigid endoscope in cholangioscopy. There is almost no description of cholangioscopy with flexible endoscopes. They champion the merits of fluorocholangiography using permanently mounted x-ray equipment in the operating room. Biliary manometry is also discussed. A chapter on the postoperative remova! of retained stones through the T-tube tract is included, but there is no significant mention of performing such an extraction via upper gastrointestinal endoscopy. In summary, this monograph presents the authors’ approach to surgery of the common duct for stones based on their own experience and is not a full account of the subject. Many of the illustrations are excellent and constitute the main merit of this work. BERNARD SIGEL, M.D.
Philadelphia, Pennsylvania
In Vitro Models for Cancer Research. Volume 1. Carcinomas of the Esophagus and Colon. Edited by M. W. Webber and L. I. Sekely. 239 pp., 69 figures, $77.00. CRC Press, Boca Raton, Florida, 1985. An introduction by Webber, a foreword by W. R. Waddell, and a preface by Webber and Sekely all extolling the potential and the contributions of in vitro experimentation in elucidating the etiopathogenesis of esophageal and colonic cancer open this volume, which is divided into an “Esophagus” and a “Colon” section.