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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_1310_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •Foreword
- •Preface
- •Contents
- •Contributors
- •Abbreviations
- •Chen’s Double-Hanging Maneuver
- •Case Presentation
- •Our Management
- •Diagnosis and Assessment
- •Liver
- •1 Resection of Large Hepatocellular Carcinoma: Hanging Technique
- •Introduction
- •Belghiti-Hanging Maneuver
- •Management
- •Outcome
- •References
- •2 Debulking of Extensive Neuroendocrine Liver Metastases
- •Introduction
- •Case 1: Mid-Gut Neuroendocrine Tumor Metastatic to the Liver
- •Case 2: Pancreas NET Metastatic to Liver
- •Overall Management of Patients with Extensive Neuroendocrine Hepatic Metasasis
- •Conclusion
- •Treatment of Neuroendocrine Liver Metastases
- •3 Resection of Centrally Located Cystadenoma/Cystadenocarcinoma
- •Introduction
- •Case 1
- •History
- •Procedure
- •Outcome
- •Case 2
- •History
- •Procedure
- •Outcome
- •Discussion
- •Anatomical Considerations
- •Enucleation Technique
- •Determining the Approach
- •References
- •4 Management of Patients with Bilateral Multi-focal Colorectal Liver Metastasis: Two-Stage Approach
- •Introduction
- •Case Presentation
- •Preoperative Assessment
- •Surgical Management
- •Outcome of Two-Stage Hepatectomy and Its Current Role
- •References
- •5 Management of Patients with Bilateral Multifocal Colorectal Liver Metastases: ALPPS
- •Case Presentation
- •My Management
- •Diagnosis and Assessment
- •Management
- •Outcome
- •Conclusion
- •References
- •6 Management of Low Rectal Cancer with Synchronous Liver Metastases
- •Introduction
- •Case Presentation 1
- •Multidisciplinary Management
- •Case Summary
- •Case Presentation 2
- •Multidisciplinary Management
- •Case Summary
- •Case Presentation 3
- •Multidisciplinary Management
- •Case Summary
- •Discussion: Symptomatic Primary Tumors
- •Neoadjuvant Therapy
- •Surgical Resection
- •Conclusion
- •References
- •7 Laparoscopic Hemihepatectomy for Hepatocellular Carcinoma
- •Case Presentation
- •Diagnosis and Assessment
- •Management
- •Outcome
- •References
- •8 Minimally Invasive Resection of Colorectal Liver Metastases
- •Case Presentation
- •Epidemiology
- •Preoperative Planning
- •Management
- •Minimally Invasive Hepatic Resection
- •Outcomes
- •Conclusion
- •References
- •9 Totally Laparoscopic Right Hepatectomy Combined with En-Bloc Partial Resection of the Inferior Vena Cava
- •Introduction
- •Case Description
- •Patient Positioning
- •Trocar Placement
- •Surgery
- •Histological Analysis and Postoperative Course
- •Conclusion
- •References
- •10 Liver Cancer Necessitating Ex Vivo Resection and Reconstruction
- •Introduction
- •Ex Vivo Resection
- •Ultrasound
- •Technical Alternatives
- •Control of Hemorrhage
- •Parenchymal Dissection
- •Transection Without Mobilization of the Right Lobe or the Anterior Approach Technique
- •Control of Hepatic Outflow
- •Haemostasis, Drain and Specimen Extraction
- •Postoperative Complication
- •Case 1
- •Case 2
- •Conclusion
- •References
- •First Case Presentation
- •Right Renal Cell Carcinoma with Tumor Thrombus Extending into the Retrohepatic Inferior Vena Cava
- •Clinical Presentation
- •Diagnosis and Assessment
- •Staging of Intracaval Extension
- •Surgical Strategy
- •Technical Aspects
- •Surgical Incisions
- •Surgery of the IVC and Hepatic Veins
- •Vascular Control of the IVC
- •Adjunct Procedures: The Venovenous Bypass and Hypothermic Perfusion Techniques [12–14]
- •IVC Resection and Reconstruction
- •Short-Term Outcome
- •Long-Term Outcome
- •Second Case Presentation
- •Liver Metastases from Renal Cell Carcinoma Following Right Nephrectomy and Inferior Vena Cava Tumor Resection
- •Surgical Strategy
- •Technical Aspects
- •Anesthetic Management
- •TVE, Venovenous Bypass, and In Situ Hypothermic Perfusion of the Liver
- •Discussion
- •Short-Term Outcome
- •Long-Term Outcome
- •References
- •Gallbladder/Bile Duct
- •12 Hilar Cholangiocarcinoma with Portal Vein Involvement
- •Case Presentation
- •Diagnosis and Assessment
- •Management and Outcomes
- •References
- •13 Hilar Cholangiocarcinoma with Hepatic Artery Involvement
- •Case Presentation
- •Surgery and Outcomes
- •Conclusion
- •References
- •14 Gallbladder Cancer with Common Bile Duct Invasion
- •Case Presentation
- •Radiographic Assessment of Locally Advanced Gallbladder Carcinoma
- •General Principles of Surgical Management
- •Management of Gallbladder Cancer with CBD Invasion
- •Operative Principles
- •Conclusion
- •Acknowledgements
- •References
- •15 Management of the Gangrenous Gallbladder
- •Case Presentation
- •Our Approach
- •Initial Presentation
- •Diagnostic Imaging
- •Tokyo Guidelines
- •Management
- •Surgical Considerations
- •Conclusion
- •References
- •16 Surgical Resection of a Type IVa Choledochal Cyst
- •Case Presentation
- •Diagnosis and Assessment
- •Incidence and Aetiology
- •Clinical Course
- •Operative Management
- •Outcome
- •References
- •17 Bile Duct Injury at the Hepatic Confluence
- •Clinical Case
- •Portoenterostomy
- •Double Barrell Anastomosis
- •Construction of a Neoconfluence
- •Partial Hepatectomy
- •Liver Transplantation
- •Conclusion
- •References
- •18 Posterior Right Disconnected Bile Duct
- •Case Presentation
- •Preoperative Assessment
- •Malignant Causes
- •Diagnostic Tools
- •Endoscopic Procedures
- •Multidisciplinary Evaluation and Operative Treatment
- •References
- •19 Management of Contralateral Bile Duct Injury Following Liver Resection
- •Case 1
- •Case 2
- •Discussion
- •Initial Presentation and Workup
- •Initial Management
- •Operative Management
- •Prevention of Contralateral Bile Duct Injury
- •Conclusion
- •References
- •20 Transplantation for Hilar Cholangiocarcinoma
- •Introduction
- •CASE 1
- •Discussion
- •CASE 2
- •Discussion
- •Conclusion
- •References
- •Pancreas
- •Case Presentation
- •Diagnosis and Workup
- •Management
- •Pre-operative Planning
- •Intra-operative Approach
- •Post-operative Course
- •Conclusion
- •References
- •Introduction
- •Anatomical Considerations
- •Preoperative Considerations
- •Surgical Considerations
- •Conclusion
- •References
- •Introduction
- •Case Presentation
- •Workup
- •Diagnosis and Staging
- •Preoperative Management
- •Operative Management
- •Peri-operative Care
- •Postoperative Care and Considerations for Follow-Up
- •References
- •Case Presentation
- •Operative Technique for Laparoscopic Distal Pancreatectomy
- •Alternative Techniques
- •Preoperative Evaluation for Pancreatic Adenocarcinoma
- •Postoperative Care
- •Surveillance
- •Conclusion
- •References
- •25 Robotic Approaches to the Patient with Pancreatic Adenocarcinoma
- •Introduction
- •Case Presentation
- •Epidemiology
- •Diagnostic Workup and Staging
- •Management
- •Robotic Pancreaticoduodenectomy
- •Perioperative Outcomes Following Robotic PD
- •Adjuvant Therapy
- •Posttreatment Surveillance and Interval Staging
- •Conclusion
- •References
- •Introduction
- •Case Studies
- •Case #1
- •Case #2
- •Results
- •Discussion
- •References
- •Case Presentation
- •Presentation
- •Imaging
- •Operative Planning: Splenic Preservation?
- •Operative Technique: Distal Pancreatectomy and Splenectomy
- •Postoperative Management
- •Conclusion
- •References
- •28 Multifocal Branch-Duct Intraductal Papillary Mucinous Neoplasm
- •Case Presentation
- •Overview of Multifocal Bd-IPMN
- •Clinical Management of Multifocal BD-IPMN
- •Total Pancreatectomy
- •Partial Pancreatectomy and Postoperative Surveillance
- •Case Continued
- •Surveillance Alone
- •Case Conclusion
- •Conclusion
- •References
- •Case Presentation
- •Diagnosis and Preoperative Management
- •Surgical Management
- •Postoperative Care
- •References
- •30 Chronic Pancreatitis: Puestow and Frey Procedures
- •Introduction
- •Etiology
- •Pathophysiology
- •Marseille, Cambridge, and Rosemont Classification Systems
- •Case Presentation: Surgical Treatment of Chronic Pancreatitis
- •Differential Diagnosis
- •Workup
- •Preoperative Evaluation for CP and a Dilated MPD
- •Operative Techniques
- •Puestow
- •Frey Modification of Beger’s Procedure
- •Outcomes and Pitfalls
- •Conclusion
- •References
- •31 Chronic Pancreatitis: Frey Procedure
- •Case Presentation
- •Diagnosis and Assessment
- •Management
- •Intraoperative Technique
- •Positioning and Preparation
- •Exposure of the Pancreas
- •Longitudinal Pancreatic Ductotomy
- •Pancreatic Head Resection
- •Roux-en-Y Pancreaticojejunostomy
- •Postoperative Management
- •Global Pearls
- •References
- •32 Total Pancreatectomy with Islet Autotransplantation
- •Case Scenarios
- •Case 1: Diffuse Small Duct Disease
- •Case 2: Hereditary Pancreatitis
- •Case 3: Salvage Pancreatectomy
- •Case 4: Recurrent Acute Pancreatitis
- •Preoperative Evaluation
- •History
- •Genetic Testing
- •Recurrent Acute Pancreatitis
- •Imaging
- •Diabetes
- •Nutritional Assessment
- •Physiologic Assessment
- •Behavioral Medicine Evaluation
- •Preoperative Counseling
- •Surgical Technique
- •Islet Cell Preparation
- •Islet Transplantation
- •Postoperative Care
- •Potential Complications
- •Long-Term Outcomes
- •References
- •33 Necrotizing Pancreatitis: Best Approaches
- •Introduction
- •Case Presentation
- •Pathophysiology and Determination of Severity
- •Medical Therapy
- •Nutrition
- •Prophylactic Antibiotics
- •Management of Pancreatic Necrosis
- •Endoscopic Necrosectomy
- •Laparoscopic Transgastric Necrosectomy
- •Video-Assisted Retroperitoneal Debridement (VARD)
- •Open Pancreatic Debridement
- •Complications
- •Conclusion
- •References
- •34 Pancreatic Pseudocyst: Operative Versus Endoscopic Approach
- •Introduction
- •Case 1
- •Case 2
- •Case 3
- •Discussion
- •Conclusion
- •References
- •Index

Case-Based Lessons in
the Management of
Complex HepatoPancreato-Biliary Surgery
Timothy M. Pawlik
Sharon Weber
T. Clark Gamblin
Editors
123

Case-Based Lessons in the Management
of Complex Hepato-Pancreato-Biliary
Surgery

Timothy M. Pawlik•Sharon Weber
T. Clark Gamblin
Editors
Case-Based Lessons
in the Management
of Complex
Hepato-Pancreato-Biliary
Surgery
123

Editors
Timothy M. Pawlik
The Ohio State Wexner Medical Center
The Ohio State University School
of Medicine
Columbus, OH
USA
Sharon Weber
Division of General Surgery
University of Wisconsin-Madison
Madison, WI
USA
T. Clark Gamblin
Medical College of Wisconsin
Milwaukee, WI
USA
ISBN 978-3-319-50867-2 ISBN 978-3-319-50868-9 (eBook)
DOI 10.1007/978-3-319-50868-9
Library of Congress Control Number: 2016959745
© Springer International Publishing AG 2017
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part
of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations,
recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission
or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar
methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specific statement, that such names are exempt from
the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this
book are believed to be true and accurate at the date of publication. Neither the publisher nor the
authors or the editors give a warranty, express or implied, with respect to the material contained herein or
for any errors or omissions that may have been made.
Printed on acid-free paper
This Springer imprint is published by Springer Nature
The registered company is Springer International Publishing AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

We dedicate this book to our families
and to our patients

Foreword
The only source of knowledge is experience
Albert Einstein (1879–1955)
We learn from our experiences. When faced with unusual and difficult situations in
which we have limited experience and are out of our comfort zone, we depend on
the experiences of other s. This is at the core of training in surgery, where residents
and fellows learn from experienced surgeons and mentors. What do you do when
you are faced with a patient with a difficult or unusual condition and do not have
ready access to a colleague with whom to discuss the case, or even seek assistance
with the operation? We depend on the literature.
The editors of this book have assembled in one source an international team of
experts in hepato-biliary and pancreatic surgery to share their experiences with the
management of difficult Hepato-Pancreato-Biliary (HPB) conditions and new
therapeutic alternatives. Collectively, the individual authors have well in excess of
300 years’ experience with complex HPB patients. The case study approach is
the foundation of this book. It allows the reader to learn from experiences in the
management of unique patients and the application of innovative techniques. The
case method provides the learner with immediate information concerning pattern
recognition of the problem at hand, the pre-operative thinking of the surgeons and,
importantly, the intraoperative management and technical approach to the patient.
Some of the patients presented are incredibly complex and represent one-of-kind
situations, others represent difficult management issues or technical challenges, and
still others present controversies in treatment. In addition, the content includes
excellent discussions of minimally invasive and robotic approaches.
Whether you are a surgeon in training or an experienced hepato-biliary pancreatic surgeon, I think you will find this text an essential complement to your
library.
Columbus, OH E. Christopher Ellison, MD, FACS
Robert M. Zollinger Professor
Department of Surgery
The Ohio State University College of Medicine
vii

Preface
Hepato-Pancreato-Biliary Surgery is a field filled with unique challenges and
requires perspe ctive for rare cases. Such cases commonly demand a set of complex
skills. While cases are not routine, the clinical scenarios demand an expertise and
insight to offer patients state of the art therapy.
Our goal was to create a case based learning resource based on authorities in the
field who share their patients and experience with the reader. Each chapter contains
relevant facts and applies expert lessons learned to a particular patient case. Perioperative and intraoperative decisions are discussed in a manner that a colleague
would share with a partner, and key points or takeaways are featured in each
chapter. The book contains a diverse team of renowned international authorities to
guide the reader through challenging HPB topics.
It is our hope that this book will serve as a resource that is often visited by
surgeons at all stages of their career. We also hope to stimulate students, residents
and fellows regarding the breadth and depth of their knowledge in HPB surgery.
Columbus, OH, USA Timothy M. Pawlik
Madison, USA Sharon Weber
Milwaukee, USA T. Clark Gamblin
ix

Contents
Part I Liver
1 Resection of Large Hepatocellular Carcinoma:
Hanging Technique
Bin-hao Zhang, Bi-xiang Zhang and Xiao-ping Chen
....................................... 3
2 Debulking of Extensive Neuroendocrine Liver Metastases
........ 17
Douglas L. Fraker and Steven K. Libutti
3 Resection of Centrally Located
Cystadenoma/Cystadenocarcinoma
.......................... 29
Emmanuel Melloul, Parissa Tabrizian and Myron E. Schwartz
4 Management of Patients with Bilateral Multi-focal Colorectal
Liver Metastasis: Two-Stage Approach
....................... 39
Dario Ribero, Roberto Lo Tesoriere and Alessandro Ferrero
5 Management of Patients with Bilateral Multifocal Colorectal
Liver Metastases: ALPPS
.................................. 57
Matteo Serenari, Martin de Santibañes, Victoria Ardiles
and Eduardo de Santibañes
6 Management of Low Rectal Cancer with Synchronous Liver
Metastases
.............................................. 73
Robert Gandy and Charbel Sandroussi
7 Laparoscopic Hemihepatectomy for Hepatocellular
Carcinoma
.............................................. 85
Go Wakabayashi
8 Minimally Invasive Resection of Colorectal Liver Metastases
Lee M. Ocuin and Allan Tsung
9 Totally Laparoscopic Right Hepatectomy Combined with
En-Bloc Partial Resection of the Inferior Vena Cava
............ 109
Christophe Bourdeaux, David Fuks and Brice Gayet
..... 95
xi

xii Contents
10 Liver Cancer Necessitating Ex Vivo Resection
and Reconstruction
....................................... 123
Jennifer Berumen and Alan Hemming
11 Resection of Renal Cell Carcinoma Involving the Liver with
Tumor Thrombus Extending into Inferior Vena Cava Requiring
Venovenous Bypass
....................................... 141
Chetana Lim, Chady Salloum, Eylon Lahat, Michael Ossesis,
Concepcion Gomez Gavara, Philippe Compagnon
and Daniel Azoulay
Part II Gallbladder/Bile Duct
12 Hilar Cholangiocarcinoma with Portal Vein Involvement
........ 167
Ryan T. Groeschl and Davi d M. Nagorney
13 Hilar Cholangiocarcinoma with Hepatic Artery Involvement
Junichi Shindoh and Yoshihiro Sakamoto
14 Gallbladder Cancer with Common Bile Duct Invasion
........... 187
Russell C. Langan and Michael I. D’Angelica
15 Management of the Gangrenous Gallbladder
.................. 201
Jean-Michel Aubin, Chad G. Ball and Henry A. Pitt
16 Surgical Resection of a Type IVa Choledochal Cyst
............. 215
J. Robert O’Neill and Rowan W. Parks
17 Bile Duct Injury at the Hepatic Confluence
.................... 227
Miguel-Angel Mercado, Mario Vilatoba
and Bruno A. Gonzalez-Nolasco
18 Posterior Right Disconnected Bile Duct
....................... 235
Umberto Cillo, Riccardo Boetto, Agostino Maria De Rose,
Domenico Bassi, Francesco Ardito and Felice Giuliante
19 Management of Contralateral Bile Duct Injury
Following Liver Resection
.................................. 245
Michael McCall, Jean-Michel Aubin and Elijah Dixon
20 Transplantation for Hilar Cholangiocarcinoma
................ 259
Caroline C. Jadlowiec and Charles B. Rosen
..... 179
Part III Pancreas
21 Pancreatic Adenocarcinoma in the Head of the
Pancreas with Portal Vein Involvement
....................... 277
Gyulnara G. Kasumova and Jennifer F. Tseng

Contents xiii
22 Implications of a Completely Replaced Right Hepatic Artery
and Pancreatoduodenectomy
............................... 289
Anubhav Mittal, Sanjay Pandanaboyana and John Albert Windsor
23 Pancreatic Adenocarcinoma in the Neck of the Pancreas
Involving the Celiac Trunk (Appleby Procedure)
............... 297
Richard A. Burkhart and Matthew J. Weiss
24 Laparoscopic Approaches to the Patient with Pancreatic
Adenocarcinoma
......................................... 311
Salila S. Hashmi and David A. Kooby
25 Robotic Approaches to the Patient with Pancreatic
Adenocarcinoma
......................................... 323
Jennifer L. Miller-Ocuin, Melissa E. Hogg, Am er H. Zureikat
and Herbert J. Zeh III
26 Pancreatic Neuroendocrine with Superior Mesenteric
Vein–Portal Vein Thrombus
................................ 339
Jeffrey A. Norton, E. John Harris and Robert T. Jensen
27 Pancreatic Neuroendocrine Tumor in Tail of Pancreas with
Splenic Vein Thrombus and Sinistral Portal Hypertension
....... 353
Christina L. Costantino and Cristina R. Ferrone
28 Multifocal Branch-Duct Intraductal Papillary
Mucinous Neoplasm
...................................... 361
Alexander P. Stark and O. Joe Hines
29 Cavernous Transformation of the Portal Vein Requiring
Temporary Mesocaval Shunt and Internal Jugular Vein
Interposition Graft
....................................... 375
George Younan, Douglas B. Evans and Kathleen K. Christians
30 Chronic Pancreatitis: Puestow and Frey Procedures
............ 385
Alex Chang and Daniel Abbo tt
31 Chronic Pancreatitis: Frey Procedure
........................ 401
Tyler S. Wahl and John D. Christein
32 Total Pancreatectomy with Islet Autotransplantation
............ 413
William P. Lancaster and Katherine A. Morgan
33 Necrotizing Pancreatitis: Best Approaches
.................... 427
Attila Nakeeb and Nicholas J. Zyromski
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