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<<< < Предыдущая 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 4950 / 5050

470 Index

augmented reality technology (cont.)

future directions 59–60

generation of virtual data 49–50, 50

head-mounted displays for laparoscopic surgery 54

hepatopancreatobiliary surgery 47–61

image overlay 53–58, 54–57

image processing techniques 47

imaging system 35

instrument tracking 52–53, 53

key points 60

laparoscope image calibration 52, 52

laparoscopic liver surgery 47–61

organ motion and deformation 58–59, 59

port placement 57–58, 58

primary steps 49

robotic surgery 57, 57

structure localization 54–57, 55, 56,57–58, 58

surgical guidance and image guidance 47–48, 48,55–57, 60 autostatic instrument stabilizer 32

balloon retractor 41 Barcelona Clinic Liver Cancer (BCLC) staging system 186, 186 benign tumors 245–246 Bernheim, Bertram M. 5–6 bevacizumab 204, 207–208 bile duct

hepatobiliary anatomy 154–155, 157, 158

historical development of minimal access HPB surgery 8–9

imaging system 33–34, 33

interventional radiology 105, 106 biliary bypass 90–91 biliary tract cancers

adjuvant therapies 190–192

anatomical classiﬁcation 190

key points 194

locally

advanced and metastatic cancers 192–194 oncological management 190–194 staging laparoscopy 94–96, 95, 96 targeted therapies in oncological management 193

biloma 105, 106 biopsy 63–64, 87–88, 100–101, 101 bipolar electrocautery 37, 38 bipolar forceps 39–40, 39

bisegmentectomy IVb and V 387 hilar lymphadenectomy 434 partial splenectomy 450 posterior sectionectomy 428 segmentectomy IVb 382, 383

bisegmentectomy 386–391, 387–389 borderline resectable disease 300–302, 300, 301–303, 301 Bozzini, Phillipp 4, 4 Brasedola, Fabrizio 8 breast cancer 219, 221, 265 Brisbane classiﬁcation 150 Budd–Chiari syndrome 163 Bulldog clamp 41

carbohydrate antigen (CA) 303–304, 307 carcinoembryonic antigen (CEA) 201 CASH see chemotherapy-associated steatohepatitis caudate lobe resection

hepatobiliary anatomy 162–165, 163–165 hilar lymphadenectomy 433–434, 434 inferior vena cava 364–368, 365

left trisegmentectomy 416–421 surgical technique 275

CEA see carcinoembryonic antigen CeA see celiac artery celiac artery (CeA) 288–290, 294 celiac axis 289–290 central

nervous system (CNS) 172–173 central venous pressure (CVP) 143, 172, 174–175, 176 cetuximab 204–207 CEUS see contrast-enhanced ultrasound CHA see common hepatic artery chemical ablation

interventional radiology 109, 111–112 primary liver cancer 187

strategies for liver and pancreas tumors 262 chemoradiation therapy 191–192, 301–306 chemotherapy

adjuvant and neoadjuvant strategies 187–188, 190–192, 203,

205–207 biliary tract cancers 191, 193–194 colorectal liver metastases 202–208, 203 hepatocellular carcinoma 188–189 noncolorectal liver metastases 217–224 solid tumors of the pancreas 301–306, 302–303, 305, 310, 310 surgical considerations for preoperative chemotherapy 207–208

chemotherapy-associated steatohepatitis (CASH) 207 cholangiocarcinoma

imaging of hepatopancreatobiliary diseases 73, 74, 76, 78 interventional radiology 111

cholangiography 57–58, 58 cholecystectomy

acquisition of laparoscopic skills 17 augmented reality technology 57–58, 58 intraoperative ultrasonography 237 surgical technique 276

choledocholithiasis 33–34 choledochoscopy 33–34, 33 chronic pancreatitis 128 cirrhosis 187 cisplatin 193–194, 222 Clavien–Dindo classiﬁcation 144 clinical risk score (CRS) 94 closed technique 35 CNS see central coagulation 171 colorectal liver metastases (CRLM)

ablative therapy 264–265, 265 adjuvant and neoadjuvant strategies 203, 205–207 concepts and deﬁnitions 200–201 conversion chemotherapy 202–208, 203 future directions 208 key points 209 oncological management 200–213 robotic surgery 121, 122 selection criteria for resection 201–202, 214–215 staging laparoscopy 93–94, 94 surgical considerations for preoperative chemotherapy 207–208

common hepatic artery (CHA) 290, 294 compression 402 computed tomography (CT)

ablative therapy 264–268 augmented reality technology 49, 55–56, 59 biliary disease 74–78 cystic lesions of the pancreas 314, 315

nervous system

Index 471

gallbladder disease 78–80 hepatopancreatobiliary diseases 62, 64, 70–82 interventional radiology 100–101, 101, 104 liver disease 70–74 living donation 279–280, 279–280 pancreatic disease 80–82 phases of contrast 65 solid tumors of the pancreas 299–300, 301–303, 309, 310 strengths and weaknesses 63

console-integrated image overlay 57, 57 contrast agents 70–71 contrast-enhanced ultrasound (CEUS) 232–233, 268 conversion chemotherapy 202–208, 203 coronary ligament 438 cosmesis 245 Couinaud classiﬁcation 149, 162 critical view of safety 8, 8 CRLM see colorectal liver metastases CRS see clinical risk score cryoablation 261 CT see computed tomography CVP see central venous pressure cystgastrostomy 453–454, 454 cystic lesions of the pancreas 311–317

clinical management 315–317 concepts and deﬁnitions 298, 311 diagnostic evaluation 315, 316 incidence 311 intraductal papillary mucinous neoplasm 298, 312,

313, 315

key points 317 lymphoepithelial cysts 314 mucinous cystic lesions of the pancreas 312–313 mucinous cystic neoplasm 312, 313, 315 pancreatic neuroendocrine tumors 314 pancreatic pseudocyst 312 primary and metastatic lesions to the pancreas 314 serous cystadenoma 311–312, 312 serous cystic lesions of the pancreas 311–312 solid pseudopapillary tumors of the pancreas 313–314

cystic

pancreatic lesions 80, 81

cytotoxic chemotherapy 188–189

data alignment 50–52, 51,57 data visualization 59 DEB see drug-eluting beads dedicated minimally invasive surgery suite 29–30, 30 Desormeaux, Antoine Jean 4 diffuse liver disease 73–74 distal cholangiocarcinoma 190–191 distal pancreatectomy (DP) 287

see also laparoscopic distal pancreatectomy

distal pancreatectomy with en bloc celiac axis resection

(DP-CAR) 290, 291 distal pancreaticosplenectomy 455–456, 456 Doppler imaging see ultrasound and Doppler imaging dorsal pancreatic artery (DPA) 289–290 DP see distal pancreatectomy DPA see dorsal pancreatic artery DPC4/SMAD4 status 304 DP-CAR see distal pancreatectomy with en bloc celiac

axis resection drug-eluting beads (DEB) 110 duodenectomy 296

EBL see estimated blood loss electrocautery 37, 38 electrosurgical devices 22 embolization therapy

colorectal liver metastases 202 interventional radiology 109–110 noncolorectal liver metastases 217 primary liver cancer 187–188

embryology, ventral primordium 296 empyema 103, 104 endoscopic retrograde cholangiopancreatography (ERCP)

hepatopancreatobiliary diseases 74, 77–78, 78 historical development of minimal access HPB surgery 9 interventional radiology 104, 112

endoscopic stapler 43, 43 endoscopic ultrasound (EUS) 309 endoscopic ultrasound-guided ﬁne needle aspiration (EUS-guided

FNA) 100

energy devices 37–39

advanced bipolar vessel sealing devices 38, 38 argon plasma coagulation 39 combined bipolar sealing and ultrasonic devices 38, 39 monopolar and bipolar electrocautery 37, 38 radiofrequency ablation 39 ultrasonic devices 38, 38, 39

ENETS see European Neuroendocrine Tumor Society enhan

ced recovery after surgery (ERAS) anesthesia 178 concepts and deﬁnitions 141–142 fast-track surgery protocols 141–142, 142 hepatopancreatobiliary surgery 141–147 key points 145 liver surgery 142–143, 144, 178 pancreas surgery 143–145, 144 postoperative complications 144–145 postoperative outcomes 144

enteral nutrition 113, 114 EORTC see European Organization for Research and Treatment of

Cancer

equipment

abdominal entry and closure 35–37 concepts and deﬁnitions 28 endoscopic stapler 43 energy devices 37–39 hemostatic agent 44 hepatopancreatobiliary surgery 28–46 imaging system 32–35 key points 45 nonenergy devices 39–43 operating room set-up 28–32 special imaging systems 34–35 tissue removal bag 43–44

ERAS see enhanced recovery after surgery ERCP see endoscopic retrograde cholangiopancreatography ergonomic considerations

optics 19 optimal position 19 patient positioning 19 training and skills acquisition 18–19

estimated blood loss (EBL)

anesthesia 175–177 hybrid and hand-assisted laparoscopy 254–255 Institute of Medicine healthcare goals 241–242 robotic surgery 123–127

472 Index

European Neuroendocrine Tumor Society (ENETS) 308 European Organization for Research and Treatment of Cancer

(EORTC) 206

EUS see endoscopic ultrasound EUS-guided FNA see endoscopic ultrasound-guided ﬁne needle

aspiration extended posterior sectionectomy 255 extended staging laparoscopy 87–88 extrahepatic biliary duct dilatation 74, 77, 78 extrahepatic cholangiocarcinoma 193 eye–hand–target–monitor axis 29–30, 29, 30, 32, 32

falciform ligament

left hepatectomy 405 left lateral sectionectomy 357, 360–361, 361 right hepatectomy 413 right trisegmentectomy 422

fast-track surgery protocols

enhanced recovery after surgery 141–142, 142 liver surgery 142–143, 144 pancreas surgery 143–145, 144 postoperative complications 144–145 postoperative outcomes 144

FDG see ﬂuorodeoxyglucose

ﬁducial registration error (FRE) 51 ﬁne needle aspiration (FNA) 100, 344 ﬁxed mounting devices 31, 31

FLR see functional liver remnant; future liver remnant

ﬂuid management 175 ﬂuorodeoxyglucose (FDG) PET/CT examinations 66

5ﬂuorouracil (5FU) 202–207 FNA see ﬁne needle aspiration FNH see focal nodular hyperplasia focal liver lesions 71–73, 71–75, 76 focal nodular hyperplasia (FNH) 72, 72, 76 FRE see ﬁducial functional liver remnant (FLR) 263 future liver remnant (FLR) volume 201–202, 208

gadolinium contrast agents 65 gallbladder cancer (GBC) 80, 95–96, 96, 191 gallbladder distention 66, 67–68 gallbladder surgery 7–8 gastric bypass 90–91 gastroduodenal artery (GDA) 289–290, 289, 462 gastroenteropancreatic neuroendocrine tumors (GEP-NET) 215 gastrointestinal cancer 219–221, 221 gastrointestinal carcinoid (GIC) neuroendocrine tumors 215 gastrointestinal stromal tumor (GIST) 223–224, 224, 296 gastrolienal ligament 449 gastrosplenic ligament

distal pancreaticosplenectomy 455 spleen-preserving pancreatectomy 458–459 total splenectomy 448

GBC see gallbladder cancer GDA see gastroduodenal artery gemcitabine 193–194, 302 GEP-NET see gastroenteropancreatic neuroendocrine tumors germ cell tumors 222 GFR see glomerular ﬁltration rate GIC see gastrointestinal carcinoid GIST see gastrointestinal stromal tumor gland transection 324–325 Glasgow Prognostic Score (GPS) 304

registration error

Glissonian pedicle approach 274–277, 355–356, 405–406, 428, 438 glomerular ﬁltration rate (GFR) 65 GPS see Glasgow Prognostic Score graft harvesting 284 grasper 40, 40 gynecological cancer 221–222

HABR see hepatic arterial buffer response HALS see hand-assisted liver resection hand-assisted laparoscopy see hybrid and hand-assisted laparoscopy hand-assisted liver resection (HALS) 253–255 Harmonic Scalpel 282 Hasson method 35 HCC see hepat head-mounted displays 54 Healey classiﬁcation 149 heat-damaged red blood cell (RBC) scans 66, 68, 69–70 hemangioma 71–72, 72, 76 hemihepatectomy

hepatobiliary anatomy 154–160 hilar vessels and hepatic vein 154–156, 154–157 landmarks for surgeons 158–160 left hemihepatectomy 158–160, 159 pericaval ligament 156–158 right hemihepatectomy 158, 159

hemodynamic function 172, 172, 174–175 hemorrhage

hepatic resection 273–274 interventional radiology 105 living donation 283 robotic surgery 121 segmentectomy IV 373 segmentectomy VIII 402 see also estimated blood loss

hemostasis 241–242, 434 hemostatic agent 44, 44, 45 hepatectomy

colorectal liver metastases 202 hilar lymphadenectomy 431–437, 432–434 Institute of Medicine healthcare goals 240, 242–245 intraoperative ultrasonography 234, 235, 351–352, 353 left hepatectomy for living donation 279–280, 284–285 noncolorectal liver metastases 220 robotic surgery 122–123 surgical technique 276, 405–409, 407,410–415, 412–413

hepatic arterial buffer response (HABR) 169 hepatic artery 154, 156, 217 hepatic artery-based therapy 193 hepatic division 149–150, 149, 150 hepat hepatic iminodiacetic acid (HIDA) scans 66, 67,78 hepaticoduodenostomy 435 hepatic pedicle clamping 177 hepatic resection

ablative therapy 258, 263 caudate lobe resection 162–165, 163–165, 275, 364–368, 365,

colorectal liver metastases 201–202, 214–215 concepts and deﬁnitions 273–274 general considerations 274 Glissonian pedicle approach 274–277, 355–356, 405–406,

hepatobiliary anatomy 148, 150, 162–165, 163–165 historical development of minimal access HPB surgery 12–13

ocellular carcinoma

ic evaluation 173

416–421, 433–434, 434

428, 438

Index 473

hybrid and hand-assisted laparoscopy 250, 253–254 Institute of Medicine healthcare goals 239, 242–245 intraoperative ultrasonography 233–235 key points 277 laparoscopic resection 217, 224–225 laparoscopic segmental liver resection 275–277 major liver resection 275 neuroendocrine liver metastases 215–218 noncolorectal liver metastases 214–230 noncolorectal, nonneuroendocrine liver metastases 218–226 segmentectomy I with resection of inferior vena cava 364–368,

365

surgical technique 274–277 technical considerations for advanced laparoscopic liver

resection 273–277

see also hepatectomy; segmentectomy

hepatic steatosis 76, 207 hepatic vein (HV)

hepatic resection 273–274 hepatobiliary anatomy 149, 150–156, 153, 158–166, 158,

162–165

hybrid and hand-assisted laparoscopy 254–255, 255 intraoperative ultrasonography 234–235, 235, 236 living donation 280, 283–284, 284

hepatobiliary anatomy 148–168

Arantius’ ligament 157–158 basic liver anatomy 149–154 bile duct 154–155, 157, 158 bisegmentectomy IVb and V 390–391 caudate lobe resection 162–165, 163–165 hemihep

atectomy 154–160

hepatic artery 154, 156 hepatic division 149–150, 149, 150 hepatic resection 148, 150, 162–165, 163–165 hepatic vein 149, 150–156, 153, 156–158, 158 hilar lymphadenectomy 435–437 hilar vessels 154–156, 154–157 important points 165–166 inferior vena cava ligament 156 intraoperative ultrasonography 161–162, 352–354 key points 166 landmarks for surgeons 158–160, 166 left hepatectomy 408–409 left lateral sectionectomy surgical technique 358–359 left lateral sectionectomy using laparoscopic single access

device 361–363 left trisegmentectomy with caudate lobectomy 419–421 liver development 150 living donor left lateral sectionectomy 445–446 mesohepatectomy 439–441 pericaval ligament 156–158 portal vein 150, 151–152, 154, 155 posterior sectionectomy 429–430 right hepatectomy 414–415 right trisegmentectomy 425–426 segmentectomy 148, 150, 160–162, 160–162 segment

ectomy IV 369–370, 373–374 segmentectomy IVa 379–381 segmentectomy IVb 384–385 segmentectomy I with resection of inferior vena cava

367–368

segmentectomy VI 394–395 segmentectomy VII 398–399 segmentectomy VIII 402–404

hepatobiliary surgery

ablative therapy for liver and pancreas tumors 257–272 anesthesia for laparoscopic liver surgery 169–184 hepatobiliary anatomy 148–168 hybrid and hand-assisted laparoscopy 250–256 Institute of Medicine healthcare goals 238–249 intraoperative ultrasonography for laparoscopic

hepatopancreatobiliary surgery 231–237 oncological management of colorectal liver metastases 200–213 oncological management of primary liver cancer 185–199 resection of noncolorectal liver metastases 214–230 technical considerations for advanced laparoscopic liver

resection 273–277

hepatocaval ligament 364, 366–367, 366, 427–428 hepatocellular adenoma 76 hepatocellular carcinoma (HCC)

ablative therapy 257, 262–264 anesthesia 171 chemotherapy 188–189 hepatic resection 274 imaging of hepatopancreatobiliary diseases 63,72–73, 73, 76 interventional radiology 108–110 key points 190 management of advanced-stage HCC 188–190 management of early-stage HCC 186–187 management of intermediate-stage HCC 188 molecularly targeted therapy 189–190, 189 neoadjuvan oncological management 185–190 robotic surgery 121, 122, 124 staging laparoscopy 88, 92–93 staging systems 186, 186

hepatoduodenal ligament

hemostatic agent 44, 45 hilar lymphadenectomy 432–433 left trisegmentectomy with caudate lobectomy 416–417 right hepatectomy 411

hepatopancreatobiliary (HPB) diseases

biliary disease 74–78 comparison of imaging modalities 63, 77 computed tomography 62, 64, 70–74 gallbladder disease 78–80 imaging appearance of focal liver lesions 76 imaging modalities 62–84 interventional radiology for malignancy and surgical

key points 82 liver disease 70–74 magnetic resonance imaging 62, 65–66, 70–74 nuclear medicine 62, 65–68 organ-speciﬁc imaging 70–82 overview of imaging modalities 62–70 pancreatic disease 80–82 staging laparoscopy of malignancies 85–99 ultrasound and Doppler imaging 62–64, 70–74

hepatopancreatobiliary (HPB) surgery

acquisition of laparoscopic skills 17–27 advent of laparoscopy 5–7 augmented reality for laparoscopic liver surgery 47–61 bile duct surgery 8–9 early development 3–5 enhanced recovery after surgery 141–147 gallbladder surgery 7–8 historical

t and adjuvant strategies 187–188

complications 100–119

development of minimal access HPB surgery 3–16

474 Index

hepatopancreatobiliary (HPB) surgery (cont.)

imaging of hepatopancreatobiliary diseases 62–84 important historical events 7 interventional radiology for malignancy and surgical

complications 100–119 intraoperative ultrasonography 231–237 laparoscopic liver surgery 12–13 laparoscopic ultrasound in liver and pancreatic

surgery 13 operating room set-up and equipment 28–46 pancreatic surgery 9–12 robotic hepatopancreatic surgery 120–140 staging laparoscopy of malignancies 85–99 terms used historically 5

hepatotoxicity 208 HIDA see hepatic iminodiacetic acid scans hilar cholangiocarcinoma 94–95, 95 hilar lymphadenectomy

anatomy ﬁgures 435–437 surgical technique 431–437, 432–434

hilar vessels 154–156, 154 Hippocrates 3 HPB see hepatopancreatobiliary human cadavers 21, 23 HV see hepatic vein hybrid and hand-assisted laparoscopy 250–256

advantages of hand-assisted method 254–255 advantages of hybrid method 252 concepts and deﬁnitions 250 disadvantages of hand-assisted method 255 disadvantages of hybrid method 252 hand-assisted technique 253–255 hand insertion technique 254 hybrid technique 251–253 key points 256 laparoscopic pancreatic surgery 344 liver hanging maneuver 251, 252 parenchymal transection 251–252, 252, 254–256, 256 surgical procedure 251, 253–254 trocar placement 251, 253 why and when to use hand-assisted method 255 why and when to use hybrid method 252–253

hydrodissection 267 hyperbilirub hypercarbia 172 hypoperfusion 463, 464

ICG see indocyanine green ICU see intensive care unit IHC see intrahepatic cholangiocarcinoma image calibration 52, 52 image guidance 47–48, 48,55–57, 60 image-guided locoregional therapy 108–112

image overlay 53–58, 54–57 imaging system 32–35

imatinib 223–224 IMV see inferior mesenteric vein indocyanine green (ICG) ﬂuorescence 34, 34, 432–433

inemia 113

cholangiocarcinoma 111 hepatic metastases 110–111 hepatocellular carcinoma 109–110

bile duct stones 33–34, 33 special imaging systems 34–35, 34, 35 standard laparoscope 32–33, 33

inferior mesenteric vein (IMV) 291–292, 292 inferior pancreaticoduodenal artery (IPDA) 288–289, 289,

292–293

inferior vena cava (IVC)

hepatic resection 273–274 hepatobiliary anatomy 156, 162–166, 163, 165 hilar lymphadenectomy 437 left hepatectomy 405, 407 living donor left lateral sectionectomy 446 pancreaticoduodenectomy 461, 462 posterior sectionectomy 427–428 right hepatectomy 411, 413 right

trisegmentectomy 424, 426

segmentectomy IV 369–372, 374 segmentectomy IVa 375–376 segmentectomy VII 396–397 segmentectomy with caudate lobe resection 364–368

INR see international normalized ratio Institute of Medicine (IOM) healthcare goals 238–249

conceptual framework 238–239, 239 effectiveness 242–245, 244 efﬁciency 246 equitability 246 general comments 239–241 key points 247 open versus minimally invasive hepatectomy 239–241, 240 patient-centeredness 245–246 safety 241–242 timeliness 246–247

institutional requirements 20 instrument tracking 52–53, 53 intensive care unit (ICU) 346 international normalized ratio (INR) 174 interventional radiology 100–119

arterial injury 105, 107 ascites management 114–115 biliary duct injury/biloma 105, 106 catheter drainage of postoperative ﬂuid collections 102–105 diagnosis 100–101 diversionary percutaneous biliary drainage for malignant

occlusion 112–113, 113

enteral nutrition feeding options 113, 114 image-guided locoregional therapy 108–112 key points 115 malignancies 105–112 palliation 112–115 pancreatic blood supply 101, 102 percutaneous biopsy 100–101, 101 portal venous hypertension 105–107, 108 postoperative complications 102–108

intraductal papillary mucinous neoplasm (IPMN)

anatomical imaging 80 management 298, 312, 313, 315 robotic surgery 128–129

intrahepatic biliary duct dilatation 74, 77, 78 intrahepatic cholangiocarcinoma (IHC) 88, 93, 193 intraocular pressure (IOP) 173 intraoperative monitoring 175 intraoperative ultrasonography (IOUS)

biliary surgery 237 bisegmentectomy IVb and V 386–387, 387–389 concepts and deﬁnitions 231 contrast enhancement in liver 232–233

segmentectomy of the pancreatic head 295

Index 475

determination of parenchymal transection plane in

segmentectomy 235, 236

ensuring intact vascularization in remnant parenchyma 235 equipment 232 hepatic resection 233–235 hepatopancreatobiliary diseases 63–64 identiﬁcation of tumor-bearing portal pedicle for

segmentectomy 235 key points 237 laparoscopic hepatopancreatobiliary surgery 231–237 laparoscopic liver surgery (video) 351–354, 352–353 laparoscopic pancreatic enucleation 452 laparoscopic versus open techniques 233–234, 233 lateral sectionectomy 234, 234 left lateral sectionectomy 355, 356–357 left trisegmentectomy with caudate lobectomy 417–418 mesohepatectomy 438 pancreas surgery 235–237 partial splenectomy 450 posterior sectionectomy 427–428, 428 remote control function 232 right hepatectomy 410 right trisegmentectomy 422–424, 423 segmentectomy IV 370–371 segmentectomy I with resection of inferior vena cava 365–366 segmentectomy VI 393–394, 393–394 segmentectomy VII 397, 397 segmentectomy VIII 401 technical requirements 231–233 visualization and dissection of HV branches in major

hepatectomy 234, 235 visualization of RHV drainage for posterosuperior

segmentectomy 235, 236

intrapancreatic choledochal cyst excision 9 intrapancreatic splenule 69–70 in vivo training 20–23, 22 IOM see Institute of Medicine IOP see intraocular pressure IOUS see intraoperative ultrasonography IPDA see inferior pancreaticoduodenal artery ipilimumab 223 IPMN see intraductal papillary mucinous neoplasm IRE see irreversib irinotecan 202–208 irreversible electroporation (IRE) 112, 259–261, 268–270, 270 irrigation equipment 41, 41 IVC see inferior vena cava

JA see jejunal artery Jakobaeus, Hans Christian 5, 6 jejunal artery (JA) 288–289, 293

Kalk, Heinz 6 Kelling, George 5, 5 Klatskin tumor 431–437 Kocher maneuver 435, 460–461, 461 KRAS 205–207

laparoscopic cholecystectomy 8 laparoscopic distal pancreatectomy (LDP) 322–328

comparative studies 341, 342 complications 325–326 conversion rate over time 325 estimated proportion of access trauma 340

le electroporation

exposure of pancreas 130–131, 131 gland transection and stump closure 324–325 historical development of minimal access HPB surgery 10–11 incision/exposure 130, 130 indications and contraindications 128–129, 338–343,

338–340

key points 334, 346 operative outcomes 325, 340–343 pancreatic mobilization and dissection 131–134, 132–133 pathological outcomes 326 patient positioning 323, 324 patient selection 323 positioning 129–130 postoperative management/complications 137 preoperative planning 129 retropancreatic dissection and vascular separation 134–136,

136–137

robotic surgery 124, 128–137 specimen extraction and abdominal closure 137 splenic conversion and preservation 323–324, 340–341 surgical

procedure and technique 129–137 survival rates 326–327 technical considerations 323–325 vascular control and pancreatic transection 134, 134–135

laparoscopic mounting devices 31–32, 31, 32 laparoscopic pancreatic enucleation (LPE) 328–329, 328

historical development of minimal access HPB surgery 10 indications and contraindications 343 key points 334, 347 operative outcomes 328–329, 343 surgical technique 451–452, 452

laparoscopic pancreatic necrosectomy 344–346 laparoscopic pancreaticoduodenectomy (LPD) 329–334

comparative studies 344, 345 concepts and deﬁnitions 329–330 historical development of minimal access HPB surgery 11 indications and contraindications 343–344 key points 334 literature review 332–333 operative outcomes 330–331, 331, 344 port placement 330

laparoscopic radiofrequency ablation (LRFA) 217 laparoscopic ultrasound (LUS)

ablative therapy 267–268 historical development of minimal access HPB surgery 13 robotic surgery 131 staging laparoscopy 86, 88

laparoscopic intrapancreatic choledochal cyst excision 9 laparoscopy-assisted method see hybrid and hand-assisted

laparoscopy

lateral position 30, 31 lateral sectionectomy

intraoperative ultrasonography 234, 234 laparoscopic single access device 360–363 living donation 278, 280–284, 442–446 surgical technique 275, 280–284 training and skills acquisition 23 see also left lateral sectionectomy

LDP see laparoscopic distal pancreatectomy left bile duct division 283, 283 left gastric artery (LGA) 289–290 left gastric vein (LGV) 291–292, 292 left

hemihepatectomy 275

left hepatectomy 279–280, 284–285, 399–400, 405–409

476 Index

left hepatic artery (LHA)

bisegmentectomy IVb and V 390 left trisegmentectomy with caudate lobectomy 417 right hepatectomy 411 segmentectomy IV 373

left hepatic vein (LHV)

hepatobiliary anatomy 149, 150–154, 153, 158–166, 162–165 left hepatectomy 405, 407 left lateral sectionectomy 355–357, 361 left trisegmentectomy with caudate lobectomy 418, 421 living donation 283–284, 284 living donor left lateral sectionectomy 446 mesohepatectomy 441 right trisegmentectomy 422–424, 426 segmentectomy IV 369–370, 374 segmentectomy IVa 375–376, 378–381 segmentectomy IVb 384

left lateral sectionectomy

anatomy ﬁgures 358–359, 361–363 intraoperative ultrasonography 351, 352, 355, 356–357 laparoscopic single access device 360–363 living donation 278, 280–284, 442–446 surgical technique 275, 280–284, 355–359, 356–357, 442–446,

443–445

training and skills acquisition 23

left lobe procedures 20 left pedicle dissection 282, 282 left portal vein (LPV)

left hepatectomy 408 left trisegmentectomy with caudate lobectomy 416–418 right hepatectomy 411, 412

left trisegmentectomy 416–421, 417–418 length

of stay (LOS) enhanced recovery after surgery 141, 143 Institute of Medicine healthcare goals 245 laparoscopic pancreatic surgery 331 robotic surgery 123–127, 138

LGA see left gastric artery LGV see left gastric vein LHA see left hepatic artery LHV see left hepatic vein Lichtleiter 4, 4 ligament of Treitz 462 LigaSure 38 liver hanging maneuver 251, 252 living donation 278–286

access and mobilization of left lateral section 282, 282 concepts and deﬁnitions 278–279 donor evaluation process 279–280 end of transection and control of left hepatic vein 283–284, 284 future directions 285 graft harvesting 284 key points and technical tips 285 left bile duct division 283, 283 left hepatectomy 279–280, 284–285 left lateral sectionectomy 278, 280–284, 442–446 left pedicle dissection 282, 282 parenchymal transection 282–283, 283 postoperative care 284–285 preparation 281, 281 special considerations 284 staging laparoscopy 93 surgical technique 280–284, 442–446, 443–445

LOS see length of stay

Louisville Statement (2008) 20 low CVP anesthesia 176 low lithotomy position 30, 31 LPD see laparoscopic pancreaticoduodenectomy LPE see laparoscopic pancreatic enucleation LRFA see laparoscopic radiofrequency ablation LUS see laparoscopic ultrasound lymph nodes

hilar lymphadenectomy 431–437, 432–434 oncological pancreatic anatomy 294, 295 pancreaticoduodenectomy 460 staging laparoscopy 87–88, 91

lymphoepithelial cysts 314

macrocystic cystadenoma 311 magnetic resonance cholangiopancreatography (MRCP)

cystic lesions of the pancreas 313, 315 hepatopancreatobiliary diseases 74, 77–78, 78, 81

magnetic resonance imaging (MRI)

ablative therapy 267–268 biliary disease 74–78 gallbladder disease 78–80 hepatopancreatobiliary diseases 62, 65–66, 70–82 liver disease 70–74 pancreatic disease 80–82 sequences, protocols, and contrast agents 70–71, 71 solid tumors of the pancreas 299, 309 strengths and weaknesses 63

magnetic resonance (MR) cholangiography 280 malignancies

ablative therapy for liver and pancreas tumors 257–272 anesthesia 171 hepatic resection 273–277 hepatobiliary anatomy 148, 163–164 hilar lymphadenectomy 431–437 hybrid and hand-assisted laparoscopy 255 image-guided locoregional therapy 108–112, 110–111 imaging of hepatopancreatobiliary diseases 63, 64, 69–70,72–78,

Institute of Medicine healthcare goals 242–247 interventional radiology 104, 105–115, 106 laparoscopi management of solid and cystic lesions of the pancreas 298–321 oncological management of colorectal liver metastases 200–213 oncological management of primary liver cancer 185–199 palliation 112–115, 113–114 pancreatic anatomy 293, 295–296 resection of noncolorectal liver metastases 214–230 robotic surgery 121, 122, 124, 128–129 segmentectomy IV 369–372 staging laparoscopy of hepatopancreatobiliary malignancies

see also individual metastases

mGPS see modiﬁed Glasgow Prognostic Score MHV see middle hepatic vein microcystic cystadenoma 311, 312 microwave ablation (MWA)

ablation zones 262 hepatocellular carcinoma 264, 266 instruments 260–261

interventional radiology 109–111, 110

strategies for liver and pancreas tumors 259, 264, 266–267

middle hepatic vein (MHV)

bisegmentectomy IVb and V 390 hepatobiliary anatomy 149, 150–154, 153, 158–166, 162–165 hilar lymphadenectomy 436 left hepatectomy 408–409 left lateral sectionectomy 355, 358, 361 left trisegmentectomy with caudate lobectomy 418, 421 mesohepatectomy 438–439, 441 right hepatectomy 415 right trisegmentectomy 422–424, 425–426 segmentectomy IV 369–372, 374 segmentectomy IVa 375–376, 376–381 segment

ectomy IVb 384

segmentectomy VIII 402, 403

mini-laparotomy 36–37, 37 minimal disease activity (MDA) 300 modiﬁed Glasgow Prognostic Score (mGPS) 304 molecularly targeted therapy 189–190, 189 monitor positioning 29, 29, 30 monopolar electrocautery 37, 38 MRCP see magnetic resonance cholangiopancreatography MRI see magnetic resonance imaging mucinous cystic neoplasm (MCN) 128–129, 312, 313,

315, 343

Mühe, Erich 7, 7 multipolar radiofrequency ablation 263 MWA see microwave ablation

nasogastric tube (NGT) 366–367, 366 National Comprehensive Cancer Network (NCCN) 300–301,

306

natural oriﬁce transluminal endoscopic surgery (NOTES) 8 NCCN see National Comprehensive Cancer Network NCNN see noncolorectal, nonneuroendocrine liver metastases necrotizing pancreatitis 344 needle biopsy 100–101 needle holder 41–42, 42 NELM see neuroendocrine liver metastases neoadjuvant therapies

colorectal liver metastases 203, 205–206 hepatocellular carcinoma 187–188, 192 solid tumors of the pancreas 302–306, 309–310

nephrogenic systemic ﬁbrosis (NSF) 65 neuroendocrine liver metastases (NELM) 215–218

ablative therapy 265 key points 226 laparoscopic resection 217 natural history 215 nonresectional therapy 217–218 published studies 216 surgery 215–216

neuroendocrine tumor 64, 69–70 NF-NET see nonfunction NGT see nasogastric tube Nitta forceps 251, 252 Nitze cytoscope 5 Nitze, Maximilian 4–5, 4 noncolorectal liver metastases (NCLM)

ablative therapy 264–265 breast cancer 219, 221 concepts and deﬁnitions 214–215 gastrointestinal cancer 219–221, 221 germ cell tumors 222 gynecological cancer 221–222 hepatic resection 214–230 key points 226 laparoscopic resection 217, 224–225 melanoma 222–223 natural history of neuroendocrine liver metastases 215 neuroendocrine liver metastases 215–218, 226 noncolorectal, nonneuroendocrine liver metastases

218–226

nonresectional therapy 217–218 patient selection for surgery 225, 225–226, 225 published studies 216, 218–224, 219, 221–225 renal cell carcinoma 222, 222 sarcoma 223–224, 224, 224 surgery 215–216 survival rates 216, 220, 223, 224–226

noncolorectal, nonneuroendocrine liver metastases (NCNN)

218–226 breast cancer 219, 221 gastrointestinal cancer 219–221, 221 germ

cell tumors 222 gynecological cancer 221–222 key points 226 laparoscopic resection 224–225 melanoma 222–223 patient selection for surgery 225, 225–226, 225 renal cell carcinoma 222, 222 sarcoma 223–224, 224, 224 studies of speciﬁc tumor types 219–224, 221–225 studies with multiple tumor types 218–219, 219 survival rates 220, 223, 224–226

nonenergy devices 39–43

bipolar forceps 39–40, 39 grasper 40, 40 needle holder and suture 41–42, 42 retractor 40, 40 suction and irrigation 41, 41 surgical clip 42–43, 42 vascular clamp 41, 41

nonfunctioning neuroendocrine tumors (NF-NET) 343 nontherapeutic laparotomy 85–86, 88, 92–96 NOTES see natural oriﬁce transluminal endoscopic surgery NSF see nephrogenic systemic ﬁbrosis

ing neuroendocrine tumors

478 Index

nuclear medicine

common nuclear scintigraphy exams 66 heat-damaged red blood cell scans 66, 68, 69–70 hepatic iminodiacetic acid scans 66, 67–68 hepatopancreatobiliary diseases 62, 65–68 somatostatin receptor scintigraphy 68

obstructive jaundice 112–113, 113 ocular effects 172–173 Olsen, Douglas 7 open technique 35 operating room set-up

autostatic instrument stabilizer 32 concepts and deﬁnitions 28 dedicated minimally invasive surgery suite 29–30, 30 hepatopancreatobiliary surgery 28–32 laparoscopic equipment 29 laparoscopic mounting devices 31–32, 31, 32 monitor positioning 29, 29, 30 optimal equipment positioning 29–30 patient positioning 30, 31 robotic surgery 130 staff positioning and ﬁxed mounting devices 31, 31

operative times (OT) 123–127, 138 opioid-related adverse events (ORADE) 178 optimal position 19 OR see overall recovery ORADE see opioid-related adverse events organ motion and deformation 58–59, 59 organ-preserving peripancreatic resection 294–296 OS see overall survival OT see operative times overall recovery (OR) 331 overall survival (OS)

colorectal liver metastases 200, 208 noncolorectal liver metastases 216, 220, 223, 224–225 solid tumors of the pancreas 300

oxaliplatin 202–208, 302

PACA see periampullary carcinoma PAI see percutaneous acetic acid injection palliation

ascites

management 114–115

diversionary percutaneous biliary drainage for malignant

occlusion 112–113, 113

enteral nutrition feeding options 113, 114 interventional radiology 112–115 staging laparoscopy 90–91

pancreas resection

cystgastrostomy 453–454, 454 distal pancreaticosplenectomy 455–456, 456 laparoscopic pancreatic enucleation 451–452, 452 pancreaticoduodenectomy 460–464, 461–464 spleen-preserving pancreatectomy 457–459, 458

pancreas-sparing duodenectomy (PSD) 11, 12, 296 pancreatectomy

interventional radiology 103–105, 103 pancreatic anatomy 288–294, 293 robotic surgery 124–137

pancreatic adenocarcinoma 82

adjuvant trials 304–305, 305 approach to patients 306–307 imaging studies 299–300 management 298, 299–307

neoadjuvant trials 305–306 preoperative prognostication 303–304 presenting signs and symptoms 299 risk factors 299 staging and borderline resectable disease 300–302, 300, 301–303,

301

staging laparoscopy 90–92, 90

pancreatic anatomy 287–297

anatomical segmentectomy of the pancreatic head 295–296, 295 arterial anatomy 288–290 basic vascular anatomy for pancreatecomy 288–294 concepts

and deﬁnitions 287–288 key points 296 organ-preserving peripancreatic resection 294–296 pancreas-sparing duodenectomy 296 venous anatomy 290–294

pancreatic cancer

interventional radiology 108, 111–112 pancreatic anatomy 293 staging laparoscopy 89–91

pancreatic ductal adenocarcinoma (PDAC) 128–129, 310, 326 pancreatic enucleation see laparoscopic pancreatic enucleation pancreatic ﬁstulas 104–105 pancreatic head adenocarcinoma 104 pancreatic neoplasm 69–70 pancreatic neuroendocrine tumors (PNET)

adjuvant therapy 309 cystic lesions of the pancreas 314 diagnosis and staging 308 imaging studies 308–309 management 299–300, 307–310, 314 natural history 215 presenting signs and symptoms 308 risk factors 307–308 solid tumors of the pancreas 299–300, 307–310

pancreaticoduodenectomy

interventional radiology 104, 106, 107 pancreatic anatomy 293 surgical technique 460–464, 461–464

pancreatic pseudocyst 312 pancreatic resection

intraoperative ultrasonography 235–237 laparoscopic pancreatic surgery 337–341, 343–344 pancreatic anatomy 287–288, 294–296

pancreatic surgery

historical development of minimal access HPB surgery 9–12 laparoscopic pancreatic surgery 322–336, 337–348 management of solid and cystic lesions of the pancreas 298–321 pancrea

pancreatitis 344–346, 347 pancreatoduodenectomy (PD) 143–145 panitumumab 204–205 parenchymal transection

tic anatomy 287–297

bisegmentectomy IVb and V 386–387, 389, 391 hepatic resection 276–277 hilar lymphadenectomy 431–437, 432–434 hybrid and hand-assisted laparoscopy 251–252, 252, 254–256,

256

intraoperative ultrasonography 235, 236 left hepatectomy 405–407, 405–407, 408–409 left lateral sectionectomy 360–361 left trisegmentectomy with caudate lobectomy 416, 418, 421 living donation 282–283, 283 living donor left lateral sectionectomy 442–445, 446

Index 479

mesohepatectomy 438 partial splenectomy 450 posterior sectionectomy 428–429, 430 right trisegmentectomy 422–424 segmentectomy IV 370–372 segmentectomy IVa 376–377, 377, 379 segmentectomy IVb 382–383, 383 segmentectomy I with resection of inferior vena cava 365, 366–

367, 366

parenchymal vascularization 235 partial splenectomy 449–450 patient positioning

anesthesia 171, 172–175, 178, 179 laparoscopic pancreatic surgery 323, 324 lateral position 30, 31 living donation 281, 281 low lithotomy position 30, 31 operating room set-up 30, 31 robotic surgery 129–130 segmentectomy VII 396 training and skills acquisition 19

patient-to-image registration 51, 51,57 Pcwp see pulmonary capillary wedge pressure PD see pancreatoduodenectomy PDAC see pancreatic ductal adenocarcinoma PEEP see positive end-expiratory pressure PEI see percutaneous ethanol injection pelvitrainer 6, 6 peptide receptor radionuclide therapy (PRRT) 217–218 percutaneous acetic acid injection (PAI) 109, 262 percutaneous biopsy 100–101, 101 percutaneous ethanol injection (PEI)

hepatocellular carcinoma 262 interventional radiology 109, 111

primary liver cancer 187 percutaneous transhepatic cholangiography (PTC) 74, 77–78 periampullary carcinoma (PACA) 91–92 pericaval ligament

Arantius’ ligament 157–158

hepatobiliary anatomy 156–158

inferior vena cava ligament 156 peripancreatic nerve plexus 292 peripancreatic nodal stations 294, 294, 295 peripan

creatic resection 294–296 peritoneal carcinomatosis 114–115 peritoneal lavage cytology 88, 91 PET see positron emission tomography Petelin, Joseph 9 PFS see progression-free survival PHA see proper hepatic artery phrenicosplenic ligament 456 PIPDA see posterior–inferior pancreaticoduodenal artery PIPDV see posterior–inferior pancreaticoduodenal vein PNET see pancreatic neuroendocrine tumors pneumoperitoneum

anesthesia 171–173, 177–178 equipment 35, 41, 44 hepatic resection 274 historical development of minimal access HPB surgery 6 hybrid and hand-assisted laparoscopy 255 Institute of Medicine healthcare goals 242

POPF see postoperative pancreatic ﬁstula porcine models 22–23, 22 portable C-arm system 33, 33

portal vein (PV)

colorectal liver metastases 202 hepatobiliary anatomy 150, 151–152, 154, 155 interventional radiology 105–107, 108 living donation 279 obstruction 105–106 pancreatic anatomy 290–291 robotic surgery 131, 133

port placement

augmented reality technology 57–58, 58 bisegmentectomy IVb and V 386 cystgastrostomy 453 distal pancreaticosplenectomy 455 hilar lymphadenectomy 431–432 laparoscopic pancreatic enucleation 451 laparoscopic pancreatic surgery 330 left hepatectomy 405, 406 left lateral sectionectomy 355, 360, 364 left trisegmentectomy with caudate lobectomy

416–417

living

donor left lateral sectionectomy 443 pancreaticoduodenectomy 460–461 partial splenectomy 449 posterior sectionectomy 427 right hepatectomy 410, 410–411 right trisegmentectomy 422–423 robotic surgery 130, 130 segmentectomy IV 369–370 segmentectomy IVa 375, 375 segmentectomy IVb 382, 382 segmentectomy VI 392 segmentectomy VII 396 segmentectomy VIII 400, 400 spleen-preserving pancreatectomy 457 total splenectomy 447 training and skills acquisition 19–20 triangulation and sectoring 19–20

positive end-expiratory pressure (PEEP) 172 positron emission tomography (PET) 66, 68 posterior–inferior pancreaticoduodenal artery (PIPDA) 288–289,

289

posterior–inferior pancreaticoduodenal vein (PIPDV) 291, 291 posterior sectionectomy 276, 427–430, 428 posterior–superior pancreaticoduodenal artery (PSPDA)

290

posterior–superior pancreaticoduodenal vein (PSPDV) 291,

291

posterior superior sectionectomy 352, 354 posterosuperior segmentectomy 235, 236 postoperative care 284–285 postoperative complications

arterial injury 105, 107 biliary duct injury/biloma 105, 106 catheter drainage of postoperative ﬂuid collections 102–105 enhanced recovery after surgery 144–145 interventional radiology 102–108 portal venous hypertension 105–107, 108 robotic surgery 137

postoperative pancreatic ﬁstula (POPF) 323, 328, 341, 343 prehepatic portal hypertension 105–106 preoperat

ive assessment 173

preoperative planning 129 pre-tied slip knot 42, 42 PrHVCL see proper hepatic vein of the caudate lobe

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