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ISTUDY
Ellis andCalne’s
Lecture Notes inGeneral Surgery
Ellis and Calne’s
https://t.me/medicina_free
Lecture Notes in General
Surgery
Edited by
Christopher Watson, MD BChir FRCS
Professor of Transplantation and Honorary Consultant Surgeon
Cambridge University Hospitals NHS Foundation Trust
Cambridge, UK
Justin Davies, MA MChir FRCS (Gen Surg)
FEBS (Coloproctology)
Consultant Colorectal Surgeon
Cambridge University Hospitals NHS Foundation Trust
Affiliated Assistant Professor
University of Cambridge
Fellow in Clinical Medicine
Downing College, Cambridge, UK
Fourteenth Edition
This fourteenth edition first published 2023
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© 2023John Wiley & Sons Ltd
Edition History
1965, 1968, 1970, 1972, 1977, 1983, 1987, 1993, 1998, 2002, 2006, 2011, 2016 by Harold Ellis, Sir Roy Y. Calne and Christopher J. E. Watson
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any
means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission
to reuse material from this title is available at http://www.wiley.com/go/permissions.
The right of Christopher Watson, and Justin Davies to be identified as the authors of the editorial material in this work has been asserted
in accordance with law.
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and should not be relied upon as recommending or promoting scientific method, diagnosis, or treatment by physicians for any
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Library of Congress Cataloging-
Paperback ISBN: 9781119862482
Cover Design: Wiley
Cover Image: © Morsa Images/Getty Images
Set in 8.5/11 pt Utopia by Straive, Pondicherry, India
in- Publication Applied for
Contents
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Author afliations, vi
Preface, viii
Acknowledgements, ix
Abbreviations, x
About the companion website, xiv
1 Surgical strategy (Justin Davies), 1
2 Human factors insurgery (Peter A. Brennan), 5
Fluid andnutrition management (Lynsey Spillman), 12
3
4 Preoperative assessment
(Hemantha Alawattegama), 20
5 Postoperative complications
(Elizabeth Tweedle), 27
6 Acute infections (Christopher Watson), 49
7 Tumours (Christopher Watson), 55
8 Shock (Vijay Sujendran), 63
9 Trauma surgery (Jonathan Morton), 70
10 Burns (Ian Grant), 79
11 The skin andits adnexae (Amer J. Durrani), 86
12 Arterial disease (Patrick Coughlin), 101
13 The heart and thoracicaorta (David P. Jenkins), 119
14 The chest andlungs (Aman Singh Coonar), 129
Venous disorders ofthe lower limb (Manj Gohel), 140
15
16 The brain andmeninges (Stephen Price), 147
17 Head injury (Stephen Price), 157
18 The spine (Rodney J. C. Laing), 170
19 Peripheral nerve injuries (Ian Grant), 182
20 The oral cavity (Kanwalraj Moar), 189
21 The salivary glands (Brian Fish), 203
22 The oesophagus (Peter Safranek), 208
23 The stomach andduodenum (Stavros Gourgiotis), 218
24 The surgery ofobesity, (Christopher Pring), 240
The small intestine (Justin Davies), 245
25
26
The appendix (Ioanna G. Panagiotopoulou), 251
The colon (Justin Davies), 259
27
28
The rectum andanal canal (Justin Davies), 274
The acute abdomen (Constantinos Simillis), 289
29
30 Intestinal obstruction andparalytic ileus
(Christopher Watson), 299
31 Hernia (Christopher Watson), 311
32 The liver (Raaj Kumar Praseedom), 323
33 The gallbladder and bileducts
(Anita Balakrishnan), 340
34 The pancreas (Raaj Kumar Praseedom), 351
35 The spleen (Christopher Watson), 364
36 The lymph nodes andlymphatics
(Christopher Watson), 367
37 The breast (Eleftheria Kleidi), 371
38 The neck (Ekpemi Irune), 389
39 The thyroid (Brian Fish), 393
The parathyroids (Ekpemi Irune), 406
40
41 The thymus (Christopher Watson), 412
42 The adrenal glands (Vasilis Kosmoliaptsis), 414
43 The kidney andureter (Alexandra J. Colquhoun), 425
44 The bladder (Alexandra J. Colquhoun), 444
45 The prostate (Arthur McPhee), 450
46 The male urethra (Arthur McPhee), 459
47 The penis (Arthur McPhee), 462
48 The testis andscrotum (Alexandra J. Colquhoun), 466
49 Transplantation surgery (Christopher Watson), 476
Index, 484
Author affiliations
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Hemantha Alawattegama
Consultant Anaesthetist
Cambridge University Hospitals NHS Foundation Trust
Anita Balakrishnan
Consultant HPB Surgeon
Cambridge University Hospitals NHS Foundation Trust
Peter A. Brennan
Consultant Maxillofacial Surgeon and Honorary
Professor of Surgery
Portsmouth Hospitals University Trust
Portsmouth
Alexandra J. Colquhoun
Consultant Urologist
Cambridge University Hospitals NHS Foundation Trust
Aman Singh Coonar
Consultant Thoracic Surgeon
Royal Papworth Hospital
Cambridge
Patrick Coughlin
Leeds Vascular Institute
Leeds
Justin Davies
Consultant Colorectal Surgeon
Cambridge University Hospitals NHS Foundation Trust
Affiliated Assistant Professor
University of Cambridge
Fellow in Clinical Medicine
Downing College, Cambridge
Manj Gohel
Consultant Vascular & Endovascular Surgeon
Cambridge University Hospitals NHS Foundation Trust
Honorary Senior Lecturer
Imperial College
London
Stavros Gourgiotis
Consultant Surgeon
Cambridge OesophagoCambridge University Hospitals NHS Foundation Trust
Ian Grant
Consultant Plastic Surgeon
Cambridge University Hospitals NHS Foundation Trust
Ekpemi Irune
Consultant Laryngology, Head & Neck Surgeon
Cambridge University Hospitals NHS Foundation Trust
David P. Jenkins
Consultant Cardiothoracic Surgeon
Royal Papworth Hospital
Cambridge
Eleftheria Kleidi
Consultant Oncoplastic Breast Surgeon
Cambridge University Hospitals NHS Foundation Trust
Vasilis Kosmoliaptsis
Honorary Consultant Abdominal Transplant, HPB
and Endocrine Surgeon
Associate Professor, Department of Surgery
University of Cambridge
Gastric Centre
Amer J. Durrani
Consultant Plastic & Reconstructive Surgeon
Cambridge University Hospitals NHS Foundation Trust
Brian Fish
Consultant ENT/Head and Neck Surgeon
Cambridge University Hospitals NHS Foundation Trust
Rodney J. C. Laing
Consultant Neurosurgeon
Cambridge University Hospitals NHS Foundation Trust
Arthur McPhee
Consultant Urologist
Cambridge University Hospitals NHS Foundation Trust
Author affiliations vii
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Kanwalraj Moar
Consultant Cleft and Maxillofacial Surgeon
Cambridge University Hospitals NHS Foundation Trust
Jonathan Morton
Consultant Colorectal Surgeon
Cambridge University Hospitals NHS Foundation Trust
Ioanna G. Panagiotopoulou
Consultant Colorectal Surgeon
Cambridge University Hospitals NHS Foundation Trust
Raaj Kumar Praseedom
Consultant HPB & Transplant Surgeon
Cambridge University Hospitals NHS Foundation Trust
Stephen Price
Honorary Consultant Neurosurgeon
Cambridge University Hospitals NHS Foundation Trust
Christopher Pring
Consultant Bariatric Surgeon
St Richard’s Hospital
Chichester
Visiting Professor
University of Surrey
Peter Safranek
Consultant Surgeon
Cambridge OesophagoCambridge University Hospitals NHS Foundation Trust
Constantinos Simillis
Consultant Colorectal Surgeon
Cambridge University Hospitals NHS Foundation Trust
Lynsey Spillman
Hepatology and Liver Transplant Dietitian
Cambridge University Hospitals NHS Foundation Trust
Vijay Sujendran
Consultant Surgeon
Cambridge Oesophago- Gastric Centre
Cambridge University Hospitals NHS Foundation Trust
Elizabeth Tweedle
Consultant Colorectal Surgeon
Cambridge University Hospitals NHS Foundation Trust
Christopher Watson
Professor of Transplantation and Honorary
Consultant Surgeon
Cambridge University Hospitals NHS Foundation Trust
Gastric Centre
Preface
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Many medical students will have effectively written
their own textbook at the end of their clinical course–
a digest of the lectures and tutorials assiduously
attended and of the textbooks meticulously read.
Unfortunately, students may approach the qualifying
examinations burdened by the thought of many pages
of excellent and exhaustive textbooks wherein lies the
wisdom required of them by the examiners. Although
the Internet is increasingly used as a source of information, we believe that there is still a serious need for
a book that briefly sets out the important facts in
General Surgery that are classified, analysed and, as
far as possible, rationalized for the revision student.
These lecture notes represent such a text; they are in
no way a substitute for the standard textbooks, but
they do draw together, in a logical way, the fundamentals of General Surgery and its subspecialties. As such
we hope it will also be of use to the junior surgeon.
We wish to point the reader to the electronic
resource accompanying the text, including case studies, radiographs and histology slides illustrating
common conditions mentioned in the text, as well as
a quiz to test the reader’s knowledge.
The first edition of Lecture Notes in General Surgery
was written by Harold Ellis and Sir Roy Calne and
published in 1965. This is the first edition without
their involvement, and we acknowledge their huge
contribution to surgery and its teaching. Surgery has
changed enormously since the days of that first edition, and each subsequent edition has tried to keep
pace with surgical practice. Never has the pace of
change been so great as it is today. The biggest
changes have been seen in the development of
specialist services, at the expense of the generalist,
and the development of multidisciplinary teams to
optimize management. Recognizing this, previous
editions have relied heavily on colleagues from other
specialties to keep chapters updated and relevant. For
this edition we have taken this further, and each chapter now has a nominated expert author – who, for
some chapters, has updated previous content; and,
for others, has written completely new content– to
ensure relevance for today’s student.
Christopher Watson
Justin Davies
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