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For the surgeon of antiquity the liver has been an organ of mystery – and danger. Attempts to repair its wounds or remove tumors were fraught with hemorrhage and often a fatal outcome. Most forays were those to remove easily accessible tumors on the liver edge, but bleeding was a feared consequence still and surgeons wielded a plucky fortitude to take on even those. Not until the mid-20th Century were surgeons able to safely excise neoplasms that lay deep within the liver substance. Jean-Louis Lortat-Jacob achieved notoriety in his famous Paris hepatectomy of 1951 but he was not the first. That distinction may have belonged to German Professor Walther Wendel in 1910 or to Japanese surgeon Ichio Honjo who reported his operation in 1950, but in Japanese. It was not picked up by the Western surgical community until 1955. Names such as Hugo Rex, James Cantlie, Jean-Louis Lortat-Jacob, Tôn Thất Tùng, Jacques Hepp, Claude Couinaud, Henri Bismuth, Thomas Starzl, Roy Calne, and a host of others highlight the extraordinary curiosity, tenacity, and skill of those surgeons who broached unknown territory to master understanding and techniques of manipulation, resection, and transplantation that were formerly considered unapproachable by the surgical world.
As research in liver disease has greatly expanded over the past few decades the etiology, pathology, and natural history of many hepatic disorders have been clearly defined. Many new and accurate diagnostic tools are now available. In spite of all this progress the treatment of many liver diseases remains ameliorative. Nevertheless a more aggressive and successful surgical approach has taken place in regard to many diseases of the liver in part due to the pioneering work of Dr. William P. Longmire, Jr. and his colleagues. Dr. Longmire was among the early advocates of liver resection of neoplasms, successfully remov ing a large benign tumor of the liver in 1946. In the following decades his contributions covered the surgical treatment of trauma, tumors, cysts, and other congenital abnormalities. He has performed hundreds of operations on patients with these disorders. In 1948 he reported a procedure now named for him, in which intractable common duct obstruction was relieved by partial left hepatectomy and cholan giojejunostomy. He was one of the first to advocate side-to-side portacaval shunt for portal hypertension. Other essential contributions by this master surgeon were the periodic reviews that covered the advances in his field. Dr. Longmire, with his scholarly approach and broad background of knowl edge in all aspects of hepatic surgery, is exceptionally qualified to write this book. He and his colleague, Dr. Ronald K. Tompkins, are to be congratulated on this complete treatise.
In this issue of Surgical Clinics of North America, a spectrum of liver surgery topics is summarized, bringing the reader up-to-date with the era of modern hepatic resection surgery. The basics of liver anatomy and history are reviewed, along with articles on hepatic cysts and liver abscess, imaging and work-up of incidental liver mass, management of benign liver lesions, hepatic resection nomenclature and techniques, laparoscopic liver resection, robotic liver surgery, emergency hepatic resection for liver trauma, repair of laparoscopic cholecystectomy injury, current approach to HCC, intra-hepatic cholangiocarcinoma, resection of metastatic colorectal cancer, neuroendocrine cancer metastases, hepatic ablation procedures, fulminant hepatic failure and when to transplant, and the current role of shunts versus TIPS for portal HTN.
Indocyanine green (ICG) fluorescence has been used for imaging purposes for more than half a century; First employed by ophthalmologists for visualizing the retinal artery in the late 1960s, the application of ICG fluorescence imaging has since been continuously expanded. Recently, advances in imaging technologies have led to renewed attention regarding the use of ICG in the field of hepatobiliary surgery, as a new tool for visualizing the biliary tree and liver tumors.
This comprehensive and critical review of current and established treatment modalities for malignant liver tumors is designed to help you sort through the proliferation of competitive approaches and choose the best treatment options for your patient. Dr. Clavien and his contributors consider all the options – radiological, surgical, pharmaceutical, and emerging/novel therapies – and help you find the best single or combined therapy. Building on the success of the previous edition, this extremely thorough revision: features a new section on Guidelines for Liver Tumors, where you will find specific strategies for treating common liver malignancies; the guidelines were prepared by the Associate Editors and take into account national and international society guidelines reflects actual practice by taking a multidisciplinary approach, with contributions from international experts who have extensive experience with this patient population achieves comprehensive and balanced coverage by having each chapter reviewed by the Editor, Deputy Editor, two Associate Editors, and at least one external reviewer includes 16 new chapters that cover liver anatomy, histologic changes in the liver, epidemiology and natural history of HCC, CCC and colorectal liver metastases, strategies of liver resection, and economic aspects as well as novel therapies facilitates the kind of daily interaction among hepatologists, hepatic surgeons, medical oncologists, radiotherapists, and interventional radiologists that is essential when treating patients with complex liver malignancies In 44 chapters organized into six major sections, the book covers the full range of liver tumors. The perfect blend of evidence and experience, Malignant Liver Tumors: Current and Emerging Therapies, 3rd Edition, illuminates the path to better patient care.
This book presents a concept of hepatic segmentation with respect to the Glissonean pedicle tree. It also outlines surgical procedures for segmentectomy and cone-unit resection. Detailed illustrations depict every important action a surgeon must consider while performing these operations.
Chronic liver failure is a frequent condition in clinical practice that encompasses all manifestations of patients with end-stage liver diseases. Chronic liver failure is a multiorgan syndrome that affects the liver, kidneys, brain, heart, lungs, adrenal glands, and vascular, coagulation, and immune systems. Chronic Liver Failure: Mechanisms and Management covers for the first time all aspects of chronic liver failure in a single book, from pathogenesis to current management. Each chapter is written by a worldwide known expert in their area and all provide the latest state-of-the-art knowledge. This volume is specifically designed to provide answers to clinical questions to all doctors dealing with patients with liver diseases, not only clinical gastroenterologists and hepatologists, but also to internists, nephrologists, intensive care physicians, and transplant surgeons.
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 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. 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. Covers all surgical approaches, both open and minimally invasive. Considers all worldwide opinions and approaches to management, and includes key data on surgical outcomes to better inform clinical decision-making. 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. 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. Features a section dedicated entirely to operative technique, plus a new historical chapter authored by Professor Jacques Belghitti: “Hepatobiliary and Pancreatic Surgery: Historical Perspective.
This book comprehensibly describes the clinical details of anatomic hepatic resection using the Glissonean pedicle approach for hepatocellular carcinoma. It includes all aspects of the surgical anatomy of the liver, preoperative management of patients, surgical techniques, and intraoperative key points to prevent postoperative complications. The first three chapters provide a general introduction to the clinical anatomy of the liver, preoperative management of patients with hepatocellular carcinoma, basic techniques for hepatic resection using the Glissonean approach, and the application of dye staining in anatomic hepatic resection. Subsequent chapters present the technical details of anatomical segmentectomy (Couinaud’s classification), sectionectomy and hemi-hepatectomy for hepatocellular carcinoma using the modified suprahilar Glissonean approach. All of these hepatectomies can be performed using simple and easily available surgical instruments. In addition, it discusses precise transection of the deepest hepatic parenchyma guided by methylene blue staining. It is a useful and timely reference for hepatobiliary surgeons, clinical staff, and medical students.
Aimed at the trainee surgeon and experienced transplant surgeon, this compendium on split-liver grafting contains articles written by faculty members of the first International Course on Split-Liver Transplantation. It covers the main aspects of the field and is geared towards helping surgeons select the best surgical techniques as well as identifying the pitfalls. The text features detailed instructions on the various procedures as well as an overview of the area.