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Blumgart's Surgery of the Liver, Biliary Tract and Pancreas, 2-Volume Set
- 7th Edition - September 13, 2022
- Editor: William R. Jarnagin
- Language: English
- Hardback ISBN:9 7 8 - 0 - 3 2 3 - 6 9 7 8 4 - 2
- eBook ISBN:9 7 8 - 0 - 3 2 3 - 6 9 7 8 5 - 9
Balancing basic science with information on everyday clinical practice, Blumgart's Surgery of the Liver, Biliary Tract and Pancreas, 7th Edition, provides you with expert guidance… Read more
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Request a sales quoteBalancing basic science with information on everyday clinical practice, Blumgart's Surgery of the Liver, Biliary Tract and Pancreas, 7th Edition, provides you with expert guidance and advances in the field so you can offer patients the most optimal diagnostic and surgical care. In two convenient volumes, Dr. William Jarnagin and his team of internationally recognized surgeons cover exactly what you need to know, including advances in diagnostic and surgical techniques, minimally invasive surgeries, new interventional diagnostic techniques, and all relevant diseases. This comprehensive, practical reference is designed to help you choose and perform the most appropriate procedures that will minimize inpatient hospital time, curtail costs, and reduce overall recovery time for your patients.
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Presents cutting-edge guidance on pathology, diagnostics, surgery and non-operative intervention of the liver, biliary tract, and pancreas in one highly regarded, authoritative reference.
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Covers all surgical approaches, both open and minimally invasive.
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Considers all worldwide opinions and approaches to management, and includes key data on surgical outcomes to better inform clinical decision-making.
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Contains 161 chapters with updated references and additional figures—more than 1,500 illustrations in all. The imaging section has been reorganized to reflect a disease-based approach.
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Includes new and expanded sections on advances in molecular characterization of benign and malignant HPB diseases, perioperative management, interventional techniques, minimally invasive surgery and robotics, and therapeutic advances for malignant disease.
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Features a section dedicated entirely to operative technique, plus a new historical chapter authored by Professor Jacques Belghitti: “Hepatobiliary and Pancreatic Surgery: Historical Perspective.”
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Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
- Cover image
- Title page
- Table of Contents
- Copyright
- Dedication
- Editors
- Contributors
- Preface
- Acknowledgments
- List of Tables
- List of Illustrations
- Volume 1
- Introduction Hepatobiliary and pancreatic surgery: Historical perspective
- History of liver surgery
- Biliary surgery
- Pancreas surgery
- The forgotten liver
- References
- Part 1. Liver, Biliary, and Pancreatic Anatomy and Physiology
- 1. Embryologic development of the liver, biliary tract, and pancreas
- Introduction
- Development of liver and bile ducts
- Pancreas
- General reading
- References
- 2. Surgical and radiologic anatomy of the liver, biliary tract, and pancreas
- Anatomy overview
- Liver
- Biliary tract
- Biliary ductal anomalies
- Anomalies of the gallbladder and cystic duct
- Bile duct blood supply
- Anatomy of biliary exposure
- Extrahepatic vasculature
- Pancreas
- Lymphatic drainage
- Nerve supply to the liver and pancreas
- References
- 3. Pancreatic physiology and functional assessment
- Endocrine pancreas
- Exocrine pancreas
- Functional assessment
- References
- 4. Assessment of hepatic function: Implications for perioperative outcome and recovery
- Assessment of liver remnant volume
- Assessment of liver remnant function
- Conclusion
- References
- 5. Liver blood flow: Physiology, measurement, and clinical relevance
- Physiology
- Measurement of liver blood flow and liver perfusion
- Clinical relevance
- References
- 6. Liver regeneration: Mechanisms and clinical relevance
- Introduction to liver regeneration
- Clinical relevance of liver regeneration
- Basic characteristics of liver regeneration
- Liver atrophy
- Clinical factors influencing liver regeneration
- Experimental strategies to promote liver regeneration
- Clinical implications
- New horizons and future perspectives
- Summary
- References
- 7. Liver fibrogenesis: Mechanisms and clinical relevance
- Molecular and cellular mechanisms of fibrosis
- Diagnosis and clinical monitoring of hepatic fibrosis
- Therapeutic strategies
- References
- 8. Bile secretion and pathophysiology of biliary tract obstruction
- Overview
- Bile secretion
- Biliary obstruction
- Summary
- References
- 9A. Molecular and cell biology of hepatopancreatobiliary disease: Introduction and basic principles
- Introduction
- Signaling pathways
- Emerging themes
- Conclusion
- References
- 9B. Molecular and cell biology of liver carcinogenesis and hepatitis
- Overview of molecular etiology
- Epidemiology
- Risk factors
- Genetic and epigenetic alterations
- Signal transduction pathways
- Liver cancer stem cells
- Hepatitis B virus (see Chapter 68)
- Hepatitis C virus (see Chapter 68)
- Future directions
- References
- 9C. Advances in the molecular characterization of liver tumors
- Overview
- References
- 9D. Advances in the molecular characterization of pancreatic cancer and pre-malignant lesions
- Pancreatic cancer overview
- Genetics of pancreatic ductal adenocarcinoma (see Chapter 9A)
- Familial pancreatic cancer
- Transcriptomic (RNA) abnormalities in pancreatic cancer (see Chapter 9A)
- Molecular genetics of other pancreatic neoplasms
- Final thoughts and perspectives
- References
- 9E. Advances in the molecular characterization of biliary tract and gallbladder cancer
- Biliary tract cancers
- Classification
- Epidemiology
- Chronic biliary inflammation and cholestasis
- Molecular pathogenesis
- Summary
- References
- 10. Fundamentals of liver and pancreas immunology
- Introduction
- Liver immune cells
- Overview of pancreatic immunology
- Cytokines
- Immune system in nonmalignant liver diseases
- Immune system in malignant liver diseases
- Future directions
- References
- 11. Infections in hepatic, biliary, and pancreatic surgery
- Risk factors for surgical-site infection
- Surgery-specific risk factors
- Summary
- References
- Part 2. Diagnostic Techniques
- 12. Clinical investigation of hepatopancreatobiliary and pancreatic disease
- Introduction
- Liver disease
- Clinical history
- Physical examination
- Clinical features of liver disease
- Gallbladder and biliary tract disease
- Pancreas
- Assessment of fitness for major hepatopancreatobiliary surgery (see Chapters 26 and 27)
- References
- 13. Cross-sectional imaging of liver, biliary, and pancreatic disease: Introduction and basic principles
- Introduction
- Ultrasound
- Computed tomography
- Magnetic resonance imaging
- Magnetic resonance imaging safety considerations
- References
- 14. Imaging features of benign and malignant liver tumors and cysts
- Introduction
- Benign liver tumors
- Malignant tumors
- References
- 15. Imaging features of metastatic liver cancer
- Overview
- Ultrasound
- Computed tomography
- PET/CT and PET/MRI
- Magnetic resonance imaging
- Summary
- References
- 16. Imaging features of gallbladder and biliary tract disease
- Benign diseases of the biliary tract
- Malignant biliary tumors
- Distal cholangiocarcinoma
- References
- 17. Imaging features of benign and malignant pancreatic disease
- Introduction to pancreatic imaging
- Congenital conditions, variants, and benign alterations
- Pancreatitis
- Cystic pancreatic lesions
- Solid pancreatic lesions
- References
- 18. The role of nuclear medicine in diagnosis and management of hepatopancreatobiliary diseases
- Radiopharmaceuticals
- Diagnostic imaging in nuclear medicine
- Nuclear medicine and liver cancer
- The role of nuclear medicine in locoregional liver therapy
- The role of nuclear medicine in hepatic arterial infusion therapy
- The role of positron emission tomography in percutaneous liver ablation
- Nuclear medicine and biliary tract cancers
- The role of nuclear medicine in nononcologic hepatobiliary pathologies
- References
- 19. Emerging techniques in diagnostic imaging
- Dual-energy computed tomography
- Functional imaging with magnetic resonance imaging
- Diagnostic criteria
- Radiomics
- Summary
- References
- 20. Direct cholangiography: Approaches, techniques, and current role
- Direct cholangiography overview
- Percutaneous transhepatic cholangiography
- Endoscopic retrograde cholangiopancreatography
- Direct cholangiography and pancreatography by percutaneous transhepatic cholangiography or endoscopic retrograde cholangiopancreatography
- Conclusion
- References
- 21. Diagnostic angiography in hepatobiliary and pancreatic disease: Indications
- Overview
- Hepatobiliary and pancreatic arterial anatomy
- Angiography indications
- Venographic techniques
- References
- 22. Endoscopic ultrasound of the biliary tract and pancreas
- Imaging and diagnosis
- Diagnosis of pancreatic cancer
- Staging of pancreatic cancer
- Diagnosis and staging of cholangiocarcinoma
- Summary
- References
- 23. Image-guided liver biopsy
- Introduction
- Needle biopsy modalities and equipment
- Image guidance modalities
- Preprocedure evaluation
- Procedural outcomes and complications
- Sample adequacy and clinical implications
- Quality assurance, biopsy limitations, and future directions
- Conclusion
- References
- 24. Intraoperative diagnostic techniques
- Overview
- Intraoperative ultrasonography
- Intraoperative cholangiography
- Staging laparoscopy
- Laparoscopic ultrasound
- Staging laparoscopy for potentially resectable disease
- References
- Part 3. Anesthetic Management, Pre- and Postoperative Care
- 25. Liver and pancreatic surgery: Intraoperative management
- Overview
- Preoperative evaluation
- Intraoperative strategies for hepatopancreatobiliary surgery
- Choice of anesthesia and hemodynamics
- Cardiopulmonary
- Special consideration liver surgery: Air embolus
- References
- 26. Nutrition and perioperative critical care in the hepatopancreatobiliary surgery patient
- Nutritional and functional assessment
- Serum biochemical markers
- Nutritional focus: Liver and biliary disease
- Nutritional focus: Pancreatic disease
- Nutrition support of HPB surgery patients
- Perioperative critical care in hepatobiliary and pancreatic surgery
- Preoperative assessment and care of patients with liver disease
- Intraoperative management
- Postoperative management
- References
- 27. Enhanced recovery programs in hepatobiliary surgery
- Introduction
- The “4 pillars” of enhanced recovery programs
- Preoperative phase
- Perioperative phase
- Postoperative phase
- Future of enhanced recovery for HB surgery
- Conclusion
- References
- 28. Postoperative complications requiring intervention: Diagnosis and management
- Imaging and image-guided therapy of complications after pancreatectomy
- Imaging and image-guided therapy of complications after hepatectomy
- References
- 29. The impact of hepatobiliary interventions on health and quality of life and health
- The concepts of health and quality of life
- Quality of life as an outcome measure in surgery: Why and when?
- Quality of life instruments and interpretation
- Quality of life studies in hepatobiliary cancer
- Challenges in health-related quality-of-life research and future directions
- References
- Part 4. Techniques of Biliary Tract Intervention: Radiologic, Endoscopic, and Surgical
- 30. Interventional endoscopy for biliary tract disease: Technical aspects
- Equipment needed for standard endoscopic retrograde cholangiopancreatography cannulation
- Endoscopic retrograde cholangiopancreatography standard cannulation technique
- Difficult biliary cannulation
- Techniques for biliary access in patients with surgically altered anatomy
- Eus-guided biliary access/drainage
- Techniques for the management of choledocholithiasis
- Techniques for the management of biliary strictures
- Techniques for the management of bile leaks
- Endoscopic management of ampullary adenomas
- References
- 31. Radiologic hepatobiliary interventions
- Radiologic hepatobiliary interventions
- References
- 32. Bile duct exploration and biliary-enteric anastomosis
- Overview
- Anatomy
- Bile duct exploration
- Biliary-enteric anastomosis
- References
- Part 5. Biliary Tract Disease
- Section I. Inflammatory, Infective, and Congenital
- A. Gallstones and Gallbladder
- 33. The natural history of symptomatic and asymptomatic gallstones
- Introduction
- Historical perspective
- Classification and nomenclature
- Prevalence and epidemiology of gallstones
- Natural history of symptomatic gallstones
- Natural history of asymptomatic gallstones
- Risk factors for gallstone disease (see Chapter 8)
- Gallstones and the microbiome
- References
- 34. Cholecystitis
- Overview
- Acute cholecystitis
- Chronic cholecystitis
- Acute acalculous cholecystitis
- Complications of cholecystitis
- References
- 35. Percutaneous treatment of gallbladder disease
- Overview
- Indications and contraindications for percutaneous cholecystectomy
- Technical aspects and complications
- Percutaneous treatment of gallstones: Techniques of historic interest
- References
- 36. Cholecystectomy techniques and postoperative problems
- Overview
- Indications
- Laparoscopic cholecystectomy techniques
- Contraindications
- Conversion to open
- Open technique
- Partial or subtotal cholecystectomy
- Anatomic variations
- Postoperative management
- Immediate postoperative complications
- Delayed complications of cholecystectomy
- Conclusion
- References
- 37A. Stones in the bile duct: Clinical features and open surgical approaches and techniques
- Overview
- Origin of choledocholithiasis
- Preoperative diagnosis
- Timing and sequence of interventions
- Surgical techniques for exploration of the common bile duct
- References
- 37B. Stones in the bile duct: Minimally invasive surgical approaches
- Introduction
- Clinical scenarios
- Techniques
- Special circumstances
- Conclusion
- References
- 37C. Stones in the bile duct: Endoscopic and percutaneous approaches
- Historical overview
- Indications for endoscopic therapy
- Endoscopic techniques
- Results of endoscopic therapy (see Chapter 30)
- Laparoscopic and percutaneous approaches to bile duct stones
- Specific clinical scenarios
- Conclusions
- References
- 38. Cholecystolithiasis and stones in the common bile duct: Which approach and when?
- Diagnostic considerations
- Cholecystolithiasis
- Choledocholithiasis (see Chapter 37)
- Challenges in adhering to the standard of care
- Special populations: Management of cholelithiasis and cholecystitis in pregnancy
- Conclusion
- References
- 39. Intrahepatic stone disease
- Overview
- Epidemiology
- Etiology
- Secondary hepatolithiasis
- Cholangiocarcinoma
- Symptoms
- Diagnosis
- Imaging diagnosis
- Abdominal ultrasound
- Abdominal computed tomography
- Magnetic resonance imaging
- Percutaneous transhepatic cholangiography and endoscopic retrograde cholangiography
- Treatment for hepatolithiasis
- Pharmacologic therapy
- Percutaneous transhepatic cholangioscopic lithotomy
- Peroral cholangioscopic lithotripsy
- Surgical treatment (see Chapter 44)
- Prognosis
- References
- B. Biliary Stricture and Fistula
- 40. Extrahepatic biliary atresia
- Introduction
- Etiology
- Clinical features diagnosis and workup
- Surgical management
- Postoperative outcomes
- Postoperative complications
- Controversies in the management of biliary atresia
- Conclusions
- References
- 41. Primary sclerosing cholangitis
- Overview
- Epidemiology
- Clinical presentation
- Diagnosis
- Other serologic abnormalities
- Imaging modalities
- Histopathology
- Etiopathogenesis
- Natural history
- Associated diseases
- Complications
- Treatment of primary sclerosing cholangitis
- Conclusion
- References
- 42. Benign biliary strictures and biliary fistulae
- Overview
- Internal biliary fistulae
- External biliary fistulae and strictures
- Bile duct injury at cholecystectomy
- Considerations of bile duct injury after other operations
- Nonsurgical conditions causing fistulae and strictures
- References
- C. Biliary Infection and Infestation
- 43. Cholangitis
- Overview
- Cholangitis
- Other etiologies of cholangitis
- Summary
- References
- 44. Recurrent pyogenic cholangitis
- Etiology and pathogenesis
- Pathology
- References
- 45. Biliary parasitic disease
- Fascioliasis
- Clonorchiasis and opisthorchiasis
- Other parasitoses of the biliary tract
- References
- D. Cystic Disease of the Biliary Tract
- 46. Bile duct cysts in adults
- Diagnosis
- Etiology
- Demographics
- Clinical features
- Imaging
- Associated hepatobiliary pathology
- Malignancy and bile duct cysts
- Treatment
- Advances in minimally invasive surgical management (see Chapter 127)
- Summary
- References
- Section II. Neoplastic
- A. General
- 47. Tumors of the bile ducts: Pathologic features
- Invasive carcinomas of the biliary tract
- Noninvasive epithelial neoplasia
- Neuroendocrine neoplasms
- Other tumors
- Tumor-like lesions
- References
- B. Benign Tumors
- 48. Benign tumors and pseudotumors of the biliary tract
- Embryologic and anatomic factors (see Chapters 1 and 2)
- Clinical presentation and diagnosis
- Papilloma and adenoma
- Granular cell tumors
- Neurofibroma
- Neuroendocrine tumors
- Leiomyomas
- Pseudotumors
- References
- C. Malignant Tumors
- 49. Tumors of the gallbladder
- Benign tumors of the gallbladder
- Gallbladder cancer
- Extent of primary resection by T stage
- Treatment
- Adjuvant therapy
- Neoadjuvant therapy
- Targeted therapy
- Surveillance
- Summary
- References
- 50. Intrahepatic cholangiocarcinoma
- Introduction
- Epidemiology and demographics
- Etiology and risk factors
- Pathogenesis
- Pathologic subtypes and mode of spread
- Clinical presentation
- Diagnosis and evaluation
- Screening
- Biomarkers for cholangiocarcinoma
- Imaging
- Staging
- Treatment
- Best supportive care
- Summary
- References
- 51A. Extrahepatic biliary tumors
- Overview
- Epidemiology and risk factors
- Tumor location and histopathology
- Clinical presentation
- Diagnostic studies (see Chapter 16)
- Preoperative evaluation and management
- Treatment
- Outcomes after resection
- Adjuvant therapy
- Palliative therapy
- Summary
- References
- 51B. Perihilar cholangiocarcinoma: Presurgical management
- Diagnosing pCCA
- Classification and staging
- Preoperative considerations to surgery for pCCA
- Optimizing the future liver remnant
- References
- 52. Interventional techniques in hilar and intrahepatic biliary strictures
- Indications for biliary drainage
- Endoscopic versus percutaneous drainage (see Chapters 20, 30, and 31)
- Preprocedure preparation
- Intraprocedural issues
- Postprocedure care
- Summary
- References
- Part 6. Pancreatic Disease
- Section I. Inflammatory, Infective, and Congenital
- A. Congenital Disorders
- 53. Congenital disorders of the pancreas: Surgical considerations
- Embryologic development of the pancreas
- Pancreas divisum
- Annular pancreas
- Pancreatobiliary maljunction
- Congenital cysts of the pancreas
- Heterotopic pancreas
- References
- B. Pancreatitis
- 54. Definition and classification of pancreatitis
- Overview
- History of the definition and classification of pancreatitis
- Definition and classification of pancreatitis in the modern era
- Autoimmune pancreatitis
- The future of pancreatitis definition and classification
- Postoperative acute pancreatitis: A new kid on the block
- References
- 55. Etiology, pathogenesis, and diagnostic assessment of acute pancreatitis
- Etiology and pathogenesis of acute pancreatitis
- Assessment of acute pancreatitis
- Summary
- References
- 56. Management of acute pancreatitis and pancreatitis-related complications
- Acute pancreatitis
- Initial management
- Critical care and the management of systemic complications
- Imaging (see Chapter 17)
- Management of necrosis
- Complications
- Extreme pancreatitis
- Discussion
- References
- 57. Etiology, pathogenesis, and diagnosis of chronic pancreatitis
- Classification systems
- Etiology of chronic pancreatitis (see Chapter 54)
- Pathogenesis
- Diagnosis of chronic pancreatitis
- Summary
- References
- 58. Management of chronic pancreatitis: Conservative, endoscopic, surgical
- Background
- Conservative therapy
- Endoscopic therapy
- Surgical therapy
- Conclusions
- References
- Section II. Neoplastic
- A. General
- 59. Tumors of the pancreas and ampulla
- Tumors of the pancreatic duct or ductal-related origin
- Neuroendocrine tumors of the pancreas (see Chapter 65)
- Tumors with acinar differentiation
- Tumor of uncertain cell lineage
- Mesenchymal and other non-epithelial tumors
- Pseudotumors of the pancreas
- Metastatic tumors (see Chapter 64)
- Tumor of ampulla and periampulla
- References
- B. Benign and Premalignant Tumors
- 60. Cystic neoplasms of the pancreas: Epidemiology, clinical features, assessment, and management
- Introduction
- Clinicopathologic variables
- Diagnostic evaluation of pancreatic cystic neoplasms
- Treatment of pancreatic cystic neoplasms
- Conclusions
- References
- C. Malignant Tumors
- 61. Pancreatic cancer: Epidemiology
- Overview
- Nonmodifiable risk factors
- Risk factors for pancreatic ductal adenocarcinoma and pancreatic cancers
- Summary
- References
- 62. Pancreatic cancer: Clinical aspects, assessment, and management
- Clinical presentation
- Diagnosis
- Treatment
- References
- 63. Duodenal adenocarcinoma
- Overview
- Presentation
- References
- 64. Pancreas as a site of metastatic cancer
- Introduction
- Clinical presentation and the challenge of diagnosis
- Patient selection
- Surgical strategy
- Renal cell carcinoma
- Colorectal cancer
- Lung cancer
- Melanoma
- Other sites
- Conclusion
- References
- D. Endocrine Tumors
- 65. Pancreatic neuroendocrine tumors: Classification, clinical picture, diagnosis, and therapy
- Introduction
- Epidemiology
- Molecular biology and somatic alterations
- Pathology and staging
- Prognosis
- Familial syndromes
- Functional tumors: Clinical features
- Nonfunctional tumors: Clinical features
- Imaging
- Surgical management
- Nonsurgical management
- Systemic therapy
- Surveillance and follow-up
- References
- 66. Chemotherapy and radiotherapy for pancreatic cancer: Adjuvant, neoadjuvant, and palliative
- Adjuvant chemoradiotherapy
- Adjuvant chemotherapy
- Neoadjuvant treatment of pancreatic cancer
- Treatment for unresectable pancreatic cancer
- Targeted therapy for pancreatic cancer
- Summary
- References
- 67. Palliative treatment of pancreatic and periampullary tumors
- Introduction
- Biliary obstruction
- Gastric outlet obstruction
- Tumor-related pain
- Palliative pancreatectomy
- Local ablative therapy
- End-of-life care
- Summary
- References
- Volume 2
- Part 7. Hepatic Disease
- Section I. Inflammatory, Infective, and Congenital
- A. Hepatitis
- 68. Chronic hepatitis: Epidemiology, clinical features, and management
- Chronic hepatitis
- Summary: Approach to surgery in patients with liver disease
- References
- 69. Hepatic steatosis, steatohepatitis, and chemotherapy-related liver injury
- Histopathology of fatty liver disease and sinusoidal injury
- Epidemiology of fatty liver disease
- Diagnosis
- Nonalcoholic steatohepatitis and hepatocellular carcinoma
- Chemotherapy-mediated hepatotoxicity
- Safety of liver resection with fatty liver disease and sinusoidal injury
- References
- B. Liver Infection and Infestation
- 70. Pyogenic liver abscess
- Overview
- Etiology
- Incidence
- Clinical presentation
- Diagnosis
- Microbiology
- Treatment
- Outcome and prognosis
- References
- 71. Amebiasis and other parasitic infections
- Amebic liver abscess
- Liver fluke disease
- Blood flukes
- References
- 72. Hydatid disease of the liver
- Introduction
- Echinococcus granulosus
- Epidemiology
- Complications
- Diagnosis
- Treatment
- Echinococcus multilocularis
- References
- C. Nonparasitic Liver Cysts
- 73. Simple cysts and polycystic liver disease: Clinical and radiographic features and surgical and nonsurgical management
- Simple cysts of the liver
- Polycystic liver disease
- Differentiation among simple cysts, isolated PCLD, and PCLD associated with ADPKD
- Conclusion
- References
- D. Hepatic Cirrhosis, Portal Hypertension, and Hepatic Failure
- 74. Cirrhosis and portal hypertension: Pathologic aspects
- Overview
- Pathogenesis and reversibility of cirrhosis
- Role of liver biopsy in advanced liver disease
- Morphologic findings in cirrhosis
- Noncirrhotic portal hypertension
- Conclusion
- References
- 75. Nonhepatic surgery in the cirrhotic patient
- Overview
- Evaluation and stratification of liver disease (see Chapter 4)
- Perioperative management and optimization
- Specific procedures
- Summary
- References
- 76. Portal hypertension in children
- Pathophysiology of portal hypertension (see Chapters 5 and 74)
- Summary
- References
- 77. Management of liver failure
- Etiology of acute liver failure
- Diagnosis
- Prognosis
- Management
- Management of specific complications (see also Chapter 26)
- References
- 78. Support of the failing liver
- Failing liver
- Nonbiologic liver support
- Biologic liver support
- Posthepatectomy liver failure
- Future directions
- References
- 79. Management of ascites in cirrhosis and portal hypertension
- A brief history of ascites and portal hypertension
- Clinical findings
- Portal hypertension and mechanisms of ascites formation
- Evaluation of ascites
- Management of ascites
- Complications
- References
- 80. Medical management of bleeding varices: Primary and secondary prophylaxis for variceal bleeding
- Introduction
- Natural history of varices
- Conclusion
- References
- 81. Portal hypertensive bleeding: Acute management
- Overview
- Emergency management
- Recurrent bleeding
- References
- 82. Portal hypertensive bleeding: Operative devascularization
- Treatment of esophagogastric varices
- Surgical anatomy, pathophysiology of varices, and effects of devascularization
- Hassab and modified hassab devascularization procedure
- Sugiura and Futagawa devascularization procedure
- Modified Sugiura-Futagawa devascularization procedure
- Laparoscopic devascularization
- Results and outcome
- References
- 83. Portal hypertensive bleeding: The role of portosystemic shunting
- Overview
- Natural history of esophageal varices
- Pharmacologic management of portal hypertension
- Endoscopic therapy of variceal hemorrhage
- Surgical shunts for bleeding esophageal varices
- Types of shunts: Technical aspects (see Chapter 84)
- Summary
- References
- 84. Techniques of portasystemic shunting: Selective and nonselective shunts
- Introduction
- Preoperative assessment
- Portacaval shunts
- Mesocaval shunts
- Distal splenorenal shunt
- Common themes in perioperative and postoperative management
- Outcomes
- References
- 85. Transjugular portosystemic shunting (TIPS): Indications and technique
- Introduction
- Indications
- Clinical assessment and risk evaluation for patients undergoing tips procedure
- Tips technique
- Complications
- References
- 86. Budd-Chiari syndrome and veno-occlusive disease
- Budd-Chiari syndrome
- Veno-occlusive disease
- Summary
- References
- Section II. Neoplastic
- A. General
- 87. Tumors of the liver: Pathologic aspects
- Hepatocellular tumors
- Biliary cell tumors
- Mesenchymal tumors
- Miscellaneous tumors
- Hematopoietic neoplasms
- Metastasis
- References
- B. Benign and Premalignant Tumors
- 88A. Benign liver lesions
- Cavernous hemangioma
- Focal nodular hyperplasia
- Hepatocellular adenoma
- Other lesions
- Regenerative processes
- References
- 88B. Cystic hepatobiliary neoplasia
- Overview
- Definition
- Mucinous cystic neoplasms of the liver (hepatobiliary cystadenoma with ovarian stroma)
- Hepatobiliary cystadenoma without ovarian stroma
- Presentation and diagnosis
- Cystadenocarcinoma
- Cystic variants of intraductal papillary mucinous neoplasm of the bile duct
- Conclusion
- References
- C. Malignant Tumors
- 89. Hepatocellular carcinoma
- Overview
- Epidemiology, risk factors, and prevention
- Molecular profile
- Screening strategies
- Clinical presentation
- Diagnosis
- Staging and prognostic evaluation
- Treatment approaches
- Future prospects
- References
- 90. Hepatic metastasis from colorectal cancer
- Principles of medical treatment of metastatic colorectal cancer
- Preoperative evaluation of patients with colorectal liver metastases
- Perioperative management
- Strategies to increase resectability (see Chapter 102)
- Prognostic and predictive factors
- Molecular determinants of outcome
- Recurrence after resection of colorectal liver metastases
- Areas of controversy and future directions
- Conclusion
- References
- 91. Hepatic metastasis from neuroendocrine cancers
- Overview
- Classification of gastroenteropancreatic neuroendocrine tumors
- Radiologic assessment of neuroendocrine liver metastasis
- Liver-directed therapy
- Systemic treatment of neuroendocrine liver metastses
- Systemic chemotherapy
- References
- 92. Hepatic metastasis from noncolorectal nonneuroendocrine tumors
- Overview
- Series summarizing multiple primary tumor types
- Series focused on one primary tumor type
- Critical evaluation of liver resection for metastatic noncolorectal nonneuroendocrine tumors
- Conclusion
- References
- 93. Hepatic tumors in childhood
- Overview
- History
- Malignant tumors
- Evaluation of a child with a hepatic mass
- Benign hepatic tumors (see Chapters 87 and 88)
- References
- D. Treatment: Nonresectional
- 94A. Hepatic artery embolization and chemoembolization of liver tumors
- Basic principles of hepatic arterial embolization therapy
- Indications
- Procedure
- Therapeutic efficacy of chemoembolization
- Complications
- Alternative approaches to liver-directed intraarterial embolization therapy
- Conclusion
- References
- 94B. Radioembolization for liver tumors
- Overview
- Rationale
- Clinically available 90Y-microspheres
- Pretreatment planning
- Clinical evidence
- Posttreatment management
- Summary
- References
- 95. External beam radiotherapy for liver tumors
- Historical context and whole-liver radiation therapy
- Partial-liver irradiation: Three-dimensional conformal radiation therapy (3D-CRT)
- Intensity-modulated radiation therapy and stereotactic body radiation therapy
- Proton beam therapy
- Conclusion
- References
- 96A. Ablative treatment of liver tumors: Overview
- Ablative technologies
- Imaging guidance
- Tumor manipulation
- Clinical application
- References
- 96B. Radiofrequency ablation of liver tumors
- Radiofrequency ablation technology
- Radiofrequency ablation procedure
- Tumor response and recurrence
- Complications of radiofrequency ablation
- Conclusion
- References
- 96C. Microwave ablation and irreversible electroporation of liver tumors
- Overview
- Physics of microwave energy
- Local tissue factors that affect thermoablation
- Technical consideration for performing microwave ablation
- Clinical results of microwave ablation
- Microwave ablation compared with other techniques
- Microwave ablation: Specific complications and future applications
- Irreversible electroporation
- Physics of irreversible electroporation
- Local tissue factors that affect irreversible electroporation
- Technique of performing irreversible electroporation in liver for tumors with vascular proximity
- Clinical results of irreversible electroporation for hepatic malignancies
- Irreversible electroporation: Future directions and complications
- References
- 96D. Cryotherapy and ethanol injection
- Cryotherapy
- Ethanol injection
- Conclusion
- References
- 97. Regional chemotherapy for liver tumors
- Overview
- Systemic chemotherapy
- Rationale for hepatic arterial chemotherapy
- Surgical technique and operative considerations
- Pump placement after major hepatectomy
- Postoperative assessment
- Technical complications of hepatic artery infusion pump placement
- Minimally invasive techniques for placement of hepatic arterial infusion pumps (see Chapter 127F)
- Placement of hepatic arterial infusion pumps using percutaneous interventional techniques
- Toxicity and response rates of hepatic arterial infusion therapy
- First-line hepatic arterial chemotherapy in unresectable liver metastases (see Chapter 90)
- Combined hepatic arterial infusion and systemic chemotherapy
- Adjuvant hepatic arterial chemotherapy after liver resection of colorectal metastases
- Hepatic arterial infusion for noncolorectal liver metastases and primary liver cancer
- Concluding remarks
- References
- 98. Systemic chemotherapy for colorectal liver metastasis: Impact on surgical management
- Introduction
- A brief history of systemic chemotherapy in colorectal liver metastases
- Preoperative chemotherapy in patients with upfront resectable disease
- Patients with initially unresectable but potentially resectable disease
- Chemotherapy-associated liver injury (see Chapter 69)
- Chemotherapy in patients with definitively unresectable disease
- Postoperative chemotherapy
- Conclusion
- References
- 99. Advances in systemic therapy for hepatocellular carcinoma
- Overview
- Hepatocellular carcinoma and cirrhosis: Two diseases in one
- Role of chemotherapy in hepatocellular carcinoma
- Biologic therapies in hepatocellular carcinoma
- Arginine metabolism
- Immunotherapy
- Molecular profiling and response to therapy (see Chapters 9B and 9C)
- Neoadjuvant and conversion therapy
- Adjuvant therapy
- Combining local and systemic therapies
- Conclusion
- References
- 100. Isolated hepatic perfusion for unresectable hepatic metastases
- Surgical technique
- Results
- Other tumor histologies
- Percutaneous hepatic perfusion
- Conclusion
- References
- E. Treatment: Resection
- 101A. Hepatic resection: General considerations
- Overview
- Conclusion
- References
- 101B. Hepatic resection for benign and malignant liver and biliary tract disease: Indications and outcomes
- Introduction
- Primary hepatic malignancies
- Secondary hepatic malignancies
- Benign and premalignant hepatic lesions (see Chapters 88 and 118)
- References
- 102A. Parenchymal preservation in hepatic resectional surgery: Rationale, indications and outcomes
- Introduction
- Terminology
- Determining “anatomic” resection margins
- Rationale for parenchymal-sparing surgery
- Technical considerations for parenchymal preservation (see Chapter 118B)
- Conclusion
- References
- 102B. Segment-oriented anatomic liver resections: Indications and outcomes
- Overview
- Liver anatomy (see introduction and Chapter 2)
- Preoperative planning
- General operative principles
- Procedures
- Acknowledgments
- References
- 102C. Preoperative portal vein embolization: Indications, technique, and results
- Introduction
- Evaluation of the future liver remnant volume to predict the safety of major hepatectomy
- Indications and contraindications for portal vein embolization
- Technical aspects of portal vein embolization
- Degree and speed of hypertrophy and risk of postoperative hepatic insufficiency
- Complications of percutaneous portal vein embolization
- Clinical outcomes
- Conclusion
- References
- 102D. Associating liver partition and portal vein ligation for staged hepatectomy: Indications and outcomes
- Indications
- Assessment of future liver remnant
- Surgical technique
- Results
- Conclusion
- References
- 103. Adjuncts to hepatic resection: From ultrasound guidance to new oncologic and technical horizons
- Introduction
- The pillars
- Conclusion
- References
- Part 8. Liver and Pancreas Transplantation
- Section I. General
- 104. Liver and pancreas transplantation immunobiology
- General considerations: Specificity and context
- Physiologic immunity
- Transplant immunity
- Immunosuppression
- Immunosuppression withdrawal and operational tolerance
- References
- Section II. Indications
- 105. Liver transplantation: Indications and general considerations
- General indications and contraindications
- General considerations
- Specific diseases
- Pediatric transplantation
- Assessment of patients for liver transplantation
- Consent
- Management of patients awaiting transplantation
- References
- 106. Liver transplantation: Perioperative anesthetic considerations
- Introduction
- Preoperative anesthetic assessment
- Intraoperative monitoring
- Intraoperative management
- Critical intraoperative events
- Special situations
- Postoperative intensive care (see Chapters 26 and 111)
- References
- 107. Liver transplantation in patients with fulminant hepatitis
- Initial recognition and management is key to prognosis
- Etiology of acute liver failure
- Management of the patient with acute liver failure (see Chapter 77)
- Prevention, recognition, and early treatment of complications
- Distinguishing patients who will improve spontaneously from those who will need liver transplantation
- Prognosis
- Preoperative management (see Chapters 26 and 106)
- Intraoperative considerations (see Chapters 25 and 106)
- Living-donor liver transplantation
- Auxiliary liver transplantation
- Liver support devices
- Conclusion
- References
- 108A. Liver transplantation for hepatocellular carcinoma
- Hepatocellular carcinoma (see Chapter 89)
- Treatment options
- References
- 108B. Liver transplantation for nonhepatocellular malignant disease
- Overview
- Hilar cholangiocarcinoma (see Chapter 51)
- Early experience with liver transplantation
- Neoadjuvant therapy and liver transplantation
- Mayo clinic experience
- Intrahepatic cholangiocarcinoma and mixed HCC/CCA
- Metastatic neuroendocrine cancer (see Chapters 65 and 91)
- Metastatic colorectal cancer (see Chapter 90)
- Hepatic epithelioid hemangioendothelioma (see Chapter 87)
- Summary
- References
- 109. Orthotopic liver transplantation: Standard donation after brain death, donation after cardiac death, and live donor – indications and outcomes
- Demand for liver transplantation
- Recipient selection
- Donor selection
- Operative techniques
- Outcomes
- Disease-specific considerations and outcomes
- Conclusion
- References
- 110. Liver transplantation in children: Indications and outcomes
- Historic overview
- Indications (see Chapter 105)
- Evaluation of the potential transplant recipient
- Contraindications
- Pediatric liver transplantation—technical challenges
- Postoperative management and complications after pediatric liver transplantation
- Immunosuppression
- Long-term outcomes of pediatric liver transplantation
- Conclusion
- References
- 111. Early and late complications of liver transplantation
- Procurement injury to the graft
- Perioperative management of coagulopathy and bleeding
- Early allograft dysfunction and primary nonfunction
- Vascular complications
- Biliary complications
- Ischemic cholangiopathy
- Renal dysfunction
- Fluid and electrolyte disturbances
- Acute cellular rejection
- Infection
- Post-transplantation lymphoproliferative disorder
- Acute immunosuppressive drug toxicity
- Recurrent hepatitis
- Bone disease
- Neuropsychiatric complications
- Hypertension and hyperlipidemia
- Conclusion
- References
- 112. Whole organ pancreas and pancreatic islet transplantation
- Whole-organ pancreas transplantation
- Pancreatic islet transplantation
- Summary
- References
- Part 9. Hepatobiliary Injury and Hemorrhage
- 113. Injuries to the liver and biliary tract
- Introduction
- Evolution of management of hepatobiliary trauma
- Anatomy and classification of hepatic trauma
- Operative management of patients with hepatic trauma
- Conclusion
- References
- 114. Pancreatic and duodenal injuries
- Introduction
- History
- Surgical anatomy of the pancreas and duodenum: A trauma surgeon’s perspective
- Diagnosis of pancreatic and duodenal trauma (imaging and grading)
- Operative exposure of injuries to the pancreas and duodenum
- Management of injuries to the pancreas
- Conclusion
- References
- 115. Aneurysm and arteriovenous fistula of the liver and pancreatic vasculature
- Introduction
- Splanchnic artery aneurysms and pseudoaneurysms
- Arterioportal fistula
- Hemangioma
- Venous abnormalities
- Pancreatic arteriovenous malformations
- References
- 116. Hemobilia and bilhemia
- Introduction
- Pathophysiology and clinical manifestations
- Etiology
- Diagnostic modalities
- Management
- References
- Part 10. Techniques of Pancreatic and Hepatic Resection and Transplantation
- 117A. Pancreaticoduodenectomy
- Operative approach
- Summary
- References
- 117B. Distal and central pancreatectomy
- Overview
- Resectional techniques
- Conclusion
- References
- 117C. Total pancreatectomy
- Introduction
- Preparation
- Positioning, incision, and exposure
- Kocher maneuver, entry of lesser sac, and identification of superior mesenteric vein
- Distal pancreas dissection and splenectomy
- Portal dissection
- Jejunal and uncinate resection
- Reconstruction
- Islet cell transplantation
- Completion total pancreatectomy in the setting of positive margin
- Postoperative care (see Chapters 26–28)
- References
- 117D. Transduodenal resection of the papilla of vater
- Introduction
- Technique
- Conclusion
- References
- 118A. Major hepatectomy and extended hepatectomy
- Introduction
- Indications
- Preoperative planning
- Relevant anatomy (also see Chapter 2)
- General considerations (inflow, outflow, parenchymal transection, ordering)
- Specific operations
- Summary
- References
- 118B. Segmental resection
- Introduction
- General principles
- Operative approach
- Procedures (also see Chapter 102B)
- References
- 119A. Hepatic resection for biliary tract cancer: Gallbladder cancer
- Introduction
- Surgical management of gallbladder cancer
- Conclusion
- References
- 119B. Hilar cholangiocarcinoma: Standard and extended resections of perihilar cholangiocarcinoma
- Overview
- Preoperative radiologic evaluation for surgical success (see Chapter 51B)
- Standard resection
- Lymphadenectomy with division of the distal bile duct
- Division of the hilar vascular structures
- Mobilization of the hemiliver and caudate lobe (see Chapters 102A and 118B)
- Liver parenchymal transection (see Chapters 102A and 118A)
- Reconstruction
- Extended resection
- Combined vascular resection (see Chapter 122)
- Hepatopancreatoduodenectomy (see Chapter 117A)
- References
- 120. Hepatic resection in cirrhosis
- Introduction
- Surgical indication
- Perioperative management in patients with liver cirrhosis (see Chapters 26 and 79)
- Management for portal hypertension
- Surgical techniques
- Conclusion
- References
- 121. Resection technique for live donor transplantation
- Donor workup
- Side and size of graft
- Donor right hepatectomy (see Chapter 118)
- Inclusion of middle hepatic vein
- Donor left hepatectomy (see Chapter 118)
- Segment II and III donor hepatectomy (see Chapter 118)
- Anatomic anomalies of the donor (see Chapter 2)
- Liver graft back-table procedure: Perfusion and trimming (see Chapter 125)
- Donor postoperative care
- Donor mortality and morbidity
- Conclusion
- References
- 122. Vascular reconstruction techniques in hepato-pancreato-biliary (HPB) surgery
- Resection and reconstruction of the inferior vena cava
- Hepatic vein resection and reconstruction
- Portal vein resection and reconstruction
- Hepatic artery resection and reconstruction
- Conclusion
- References
- 123. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): Techniques
- Background
- Anatomic considerations (also see Chapters 2 and 102D)
- Surgical technique (also see Chapter 102D)
- Technical variations
- Interval management and timing of stage 2
- ALPPS for special indications
- Summary
- References
- 124. Ex vivo and in situ hypothermic hepatic resection
- History of hypothermic perfusion and ex vivo techniques
- In situ hypothermic perfusion
- Ante situm procedure
- Ex vivo liver resection
- References
- 125. Techniques of liver replacement
- Historic overview
- Donor operation
- Recipient operation
- Pediatric considerations
- Living donor allograft implantation (see Chapter 121)
- References
- 126. Techniques of pancreas transplantation
- Introduction
- History of pancreas transplantation (also see Chapter 112)
- Indications and types of pancreas transplant (see Chapter 112)
- Evaluation of the pancreas transplant recipient (see Chapter 112)
- Donor selection (see Chapter 112)
- Surgical technique
- Surgical complications (also see Chapters 28 and 112)
- Long-term complications of diabetes
- Conclusion
- References
- 127A. Minimally invasive techniques in HPB surgery: laparoscopic and robotic: General principles and considerations
- References
- 127B. Minimally invasive distal and central pancreatectomy
- Introduction
- Laparoscopic distal pancreatectomy
- Splenic preservation
- Central pancreatectomy
- Reconstruction (see Chapters 117A and 117B)
- Robotic approaches to minimally invasive distal and central pancreatectomy
- References
- 127C. Minimally invasive pancreaticoduodenectomy
- Introduction
- Indications
- Operative technique
- Perioperative outcomes
- Oncologic outcomes
- Learning curve and training
- References
- 127D. Minimally invasive segmental hepatic resection
- Introduction
- General principles
- Surgical technique (“cauliflower” technique)
- Specific cases (examples)
- Preventing and handling postoperative complications (see Chapters 27 and 28)
- Future prospects
- References
- 127E. Laparoscopic major and complex liver resection
- Terminology and definitions
- Indications
- Tumor size and location
- Tumor pathology
- Safety and benefits
- Oncologic outcomes
- Surgical technique
- Specific hepatectomy procedures (see Chapters 118A, 118B, and 127D)
- Conclusion
- References
- 127F. Robotic-assisted placement of hepatic arterial infusion pump
- Introduction
- Technique
- Anatomic considerations
- Sequencing of concomitant resection
- References
- 128. Minimally invasive surgery techniques in transplantation
- Donor selection
- Operating room setup
- Anesthetic considerations
- Equipment
- Management of parenchymal bleeding
- Laparoscopic right hepatectomy (also see Chapter 127E)
- Laparoscopic left hepatectomy with MHV and the caudate lobe (also see Chapter 127E)
- Laparoscopic left lateral sectionectomy (also see Chapter 127D)
- Postoperative considerations
- Transition from open to a laparoscopic program and disaster planning
- References
- Index
- No. of pages: 2162
- Language: English
- Edition: 7
- Published: September 13, 2022
- Imprint: Elsevier
- Hardback ISBN: 9780323697842
- eBook ISBN: 9780323697859
WJ
William R. Jarnagin
Affiliations and expertise
Chief, Hepatopancreatobiliary Service, Benno C. Schmidt Chair in Surgical Oncology, Memorial Sloan Kettering’s Cancer Center, New York, New York