Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_1444_Библиотеки_им_академика_М_И_Перельмана.pdf
Chapter 34 / Interventional Radiology Support of HPB Surgery 431
Pitt HA, Venbrux AN, Coleman J, et al. Intrahepatic stones: the transhepatic team
approach. Ann Surg 1994;216(5):527–535; discussion 535–537. PMID: 8185402(Pub
Med-indexed for MEDLINE)
van Lienden KP, et al. Portal vein embolization before liver resection: a systematic
review. Cardiovasc Intervent Radiol 2013;36:25–34.
Zyromski NJ, Viera C, Stecker M, et al. Improved outcomes in postoperative and pan-
creatitis-related visceral pseudoaneurysms. J Gastrointest Surg 2007;11(1):50–55.
433
Note: Page numbers followed by “f ” indicate gures; those followed by “t” indicate
tabular material.
A
Abdominal pain
in acute pancreatitis, 15
in chronic pancreatitis, 28
in SOD, 302
Abdominal x-rays for gallbladder disease,
286
Ablation technique
for colorectal liver metastases, 183–184
for hepatocellular carcinoma, 238–239
for metastatic colorectal cancer, 241
for neuroendocrine carcinoma, 198
Ablative technologies
microwave energy technology, 163
radiofrequency-assisted parenchymal
transection, 162–163, 166
Accessory duct of Santorini, 3, 4
Acinar cells, 11
carcinoma of, 39
Acute ascending cholangitis. See
Cholangitis
Acute cholecystitis, 290. See also
Cholecystitis
cholecystectomy for, 291
cholecystoenteric stula, 293–296
emphysematous cholecystitis, 292, 293f
gallbladder
empyema, 291, 292f
gangrene of, 292
perforation, 292, 294f
outcomes of, 298
Acute pancreatitis (AP)
diagnosis of, 14–18
epigastric pain, 14
features, 14–15
imaging in, 16–18
severity of, 15–16
endoscopic retrograde
cholangiopancreatography, 402
etiology of, 14, 15t
incidence of, 14
management of, 18–25
mild AP, 18–19
necrotizing pancreatitis, 19, 21–23
severe acute pancreatitis, 19–25
onset of, 15
outcomes of, 25
pathophysiology of, 14
Acute variceal bleeding, 134–137
balloon tamponade, 135
endoscopic treatment, 135
medications for, 134–135
octreotide infusion, 135
surgical shunt creation, 136–137
TIPS procedure, 136
treatment options for, 135, 136f
vasopressin administration, 135
Adjuvant chemotherapy, for PDAC, 49
Adjuvant therapy, for PDAC, 48–49
Aloka ultrasound unit, console of, 140, 141f
Alveolar echinococcosis (AE), 207, 210–211
Amebic liver abscess
diagnosis of, 213
presentation of, 212
treatment of, 213
American Association for the Study of Liver
Diseases (AASLD), for HCC, 169, 170f
American Joint Committee on Cancer
(AJCC) staging
for hilar bile duct cancer, 335, 337t
for pancreatic neuroendocrine
neoplasms, 73, 74t
for PDAC, 43, 44t
Angiomyolipomas (AML)
diagnosis of, 218
presentation of, 218
treatment of, 220
Annular pancreas (AP), 4–5
Antibiotics
for acute cholangitis, 276t
for necrotizing pancreatitis, 22
for SAP management, 20
A P. See Acute pancreatitis (AP)
Argon beam coagulator, 162
Arterial blood supply, of pancreas, 5–7, 6f
Asymptomatic gallstones, 283
Ataxia-telangiectasia, 40
Atlanta classication, for AP severity, 16
B
Bacteriology, in biliary surgery, 271–272
Balloon dilation, for SOD treatment, 308
INDEX
Index434
Balloon tamponade, for acute variceal
bleeding, 135
Band ligation, for acute variceal bleeding,
135
Barcelona Clinic Liver Cancer (BCLC)
staging system, for HCC, 171, 171f,
234, 235, 426
Beger procedure, for chronic
pancreatitis, 33, 35f–36f
Benign cystic liver lesions
amebic liver abscesses, 212–213, 214t
cystadenoma, 206–207
hydatid cysts, 207–208, 208f, 209t,
210–211
polycystic liver disease, 205–206, 206f
pyogenic liver abscesses, 211–212, 212f
simple hepatic cysts, 204–205
Benign solid liver lesions
angiomyolipomas, 218, 220
focal nodular hyperplasia, 215
hemangiomas, 213, 215
hepatic adenomatosis, 217
hepatocellular adenoma, 215–217, 217f
management of, 219t, 220
nodular regenerative hyperplasia,
217–218
Bile duct injury (BDI)
etiology of, 357–359
incidence of, 354
management of, 365–370
algorithm for, 365, 366f
intraoperative cholangiogram,
366, 367f
postoperative cholangiogram, 369f
primary end-to-end repair, 367–368
Roux-en-Y hepaticojejunostomy,
367, 368f
Roux-en-Y limb of jejunum, 368–369
outcomes/follow-up of, 370
Bile ducts
blood supply of, 269–270, 269f
complications of LT
anastomotic strictures, 378
biliary leak, 378
intrahepatic strictures, 378
extrahepatic, 268–269
and liver resections, 259–260, 261f
Bile leak
CT scan, 227
denition of, 226
diagnosis and management of,
226–227, 228f
endoscopic retrograde
cholangiopancreatogram, 227
percutaneous transhepatic
cholangiogram, 227
preoperative and intraoperative
considerations, 227–228
Bile salts, 272t, 273
Biliary anastomosis, 82
Biliary anatomy
bile ducts
blood supply of, 269–270, 269f
extrahepatic, 268–269
and liver resections, 259–260, 261f
gallbladder
agenesis of, 266
cystic artery, 266–267
cystic duct, 266, 267f
double gallbladder, 266
hepatocystic triangle, 266
liver
and bile duct drainage, 259–260, 261f
caudate lobectomy, 255
brous capsules and attachments,
265–266
hemihepatectomies, 258f
hepatic artery (See Hepatic artery)
and hepatic veins, 262–263, 263f
plate-sheath system, 263–265, 264f,
265f
and portal veins, 260, 262, 262f
prevailing pattern, 260f
sectionectomies, 258f
segmentectomies, 259f
trisectionectomies, 259f
Biliary cysts, classication system of, 325,
326f, 327
Biliary ducts
choledochal cysts (See Choledochal
cysts (CCs))
computed tomography, 392–393
endoscopic retrograde
cholangiopancreatography, 394
magnetic resonance
cholangiopancreatography,
393–394, 394f
percutaneous transhepatic
cholangiography, 394
ultrasound, 392
Biliary dyskinesia, 286
Biliary stula, 107. See also Bile leak
minimally invasive biliary surgery,
351, 352
Biliary leak
clinical presentation of, 359
complications of LT, 378
denition of, 354
diagnosis of, 359–361
cholangiography, 359
endoscopic retrograde
cholangiopancreatography,
359–360, 361f
HIDA scintigraphy, 360
laboratory studies, 359
magnetic resonance
cholangiopancreatography, 360, 363f
percutaneous transhepatic puncture,
359, 360, 362f
ultrasonography, 359
etiology of, 354–357, 355t
mangement of, 361–365
after cholecystectomy, 361–362
after liver resection, 362, 364
after liver transplantation, 364
after trauma, 364–365
Index 435
Biliary malignancies
diagnosis of, 333–335
etiology of, 332–333
management of
preoperative planning, 336–340
preoperative staging, 335–336
operative indications and therapy,
340–342
outcomes of, 342–343, 342f
postoperative complications,
prevention and treatment of, 342
Biliary obstruction, 274
Biliary sludge, 279
Biliary stenting, for SOD treatment, 309
Biliary surgery
infections in, 274–275
acute ascending cholangitis,
275–277, 276t
acute cholecystitis, 277–278
bacteriology, 271–272
etiology of obstruction, 274
hepatic resection, 274, 275
host defense mechanism, 272–273,
272t
inferior and superior mesenteric
venous systems, 271
pathophysiology, 274
minimally invasive (See Minimally
invasive biliary surgery)
Biliary system, IOUS of, 148–149,
149f, 150f
Biliary-enteric anastomosis, 350–351, 350f
Bilomas. See Bile leak
Biochemical markers, of AP severity,
15, 16t
Bipolar electrosurgery, 159
Bipolar vessel-sealing devices, 167t
Enseal, 160–161
LigaSure, 159–160
PlasmaKinetic tissue management
system, 161–162
salient dissecting sealer, 161
Bismuth-Corlette classication scheme
for hilar cholangiocarcinoma, 341
of malignant biliary stricture, 335, 336f
Bladder drainage technique, 381, 382
Bland embolization, 426
for HCC, 237
Borderline resectable tumor, 43–44
Botulinum toxin (Botox) injection, for
SOD, 309
C
Calcineurin inhibitors, 380
Cambridge Classication System, for
chronic pancreatitis, 29t
Cancer of the Liver Italian Program
(CLIP) system, 234, 235
Carcinoembryonic antigen (CEA), 57, 76,
180, 334
Carcinoid syndrome, 188, 188f
Caroli disease, 326f, 327, 329, 330
Caudate lobectomy, 255
Cava-preserving technique, for LT, 375,
377f, 378
Cavitron Ultrasonic Surgical Aspirator
(CUSA), 163–164
CBD stones. See Common bile duct
(CBD) stones
Celiac plexus block (CPB), 405–406, 406f
Celiac plexus neurolysis (CPN), 405–406
Central pancreatectomy, 87
Central venous pressure (CVP)
anesthesia concept, for liver
resections, 225
Centroacinar cell, 11
Chemoembolization, 237, 426, 427
Chemotherapy
for colorectal liver metastases, 183, 183f
for hepatocellular carcinoma, 239
for metastatic colorectal cancer, 240
for neuroendocrine carcinoma, 199–201
Chemotherapy-associated liver injury
(CALI), 230
Child-Pugh score, 113, 114t, 234
Child-Turcotte-Pugh (CTP) score, 130,
130t, 138
Cholangiocarcinoma (CCA)
denition of, 239
liver transplant for, 240
yttrium-90 microspheres, 240
Cholangitis
causes of, 275
diagnosis of, 275, 276
drainage of, 276, 277
Reynolds pentad, 275
Cholecystectomy, 19
for acute cholecystitis, 291
biliary leak mangement after, 361–362
Cholecystitis
acute, 284–286, 285f
chronic, 284
infections in biliary surgery
causes of, 277
complications, 277, 278
diagnosis of, 277
gallbladder perforation, 278
laparoscopic cholecystectomy, 277,
278
Cholecystokinin-Tc-HIDA scan, for
biliary dyskinesia, 286
Choledochal cysts (CCs)
classication system, 325, 326f, 327
denition of, 325
diagnosis
imaging techniques, 327–328
presentation of, 327
etiology of, 325
outcome/follow-up, 330
prevalence of, 325
surgical management
complete cyst resection, 328, 329
intrahepatic disease and cirrhosis,
329, 330
intrahepatic involvement, 329
simple cyst excision, 329
Index436
Choledochocele, 327
Choledochoduodenostomy, for CBD
stones, 323
Choledocholithiasis, 393f
Cholescintigraphy
gallbladder, 391–392, 392f
gallbladder disease, 287–288, 288f
Cholestatic liver disease, 373, 374t
Chronic cholecystitis
laparoscopic cholecystectomy for,
288–290, 290f
outcomes of, 296, 298
Chronic pancreatitis (CP)
clinical presentation of, 28
diagnosis of, 29
endoscopic management of, 29–30
endoscopic retrograde
cholangiopancreatography,
401–402
epidemiology of, 27
features of, 151, 152f
genes implicated in, 28t
pathogenesis of, 27–28
risk factors for, 27
surgical management of, 30–37
Beger procedure, 33, 35f–36f
distal pancreatectomy, 35
duodenum-preserving pancreatic
head resection, 33, 35f–36f, 37t
Frey procedure, 31, 34f
goals for surgery, 30
LDP, 37
longitudinal pancreaticojejunostomy,
31, 32t–33t
minimally invasive pancreatic
surgery, 37
pancreatoduodenectomy, 31
TP-IAT, 36–37
ultrasound characteristics of, 152t
Cirrhosis
acute variceal bleeding (See Acute
variceal bleeding)
Child-Pugh score, 113, 114t
clinical manifestations of
ascites, 132–133
esophageal varices, 134
hepatic encephalopathy, 132
pulmonary complications, 131–132
renal, 130–131
spontaneous bacterial peritonitis,
134
diagnosis of, 129–130
etiology of
causes of, 127, 128t, 129
pathophysiology of, 126–127
evolution of, 126, 127f
liver transplantation, 137–138
MELD, 113
physical ndings in, 129t
preoperative considerations of, 138
stellate cells, 126
Cirrhosis, laparoscopic resection for
HCC, 246
Classic laparoscopic BDI, 357, 358f
Classical vs. pylorus-preserving PD, 47
Coagulopathy, laparoscopic resection for
HCC, 246
Colorectal cancer (CRC), risk factors
for, 178
Colorectal liver metastases (CRLM)
diagnosis of, 178–180
management of
operative strategy, 184
preoperative considerations,
180–184
outcomes/follow-up, 185, 185t
resectability for, 180–181, 181t
Colorectal metastases, laparoscopic liver
resection for, 245–246
Combined endoscopic and percutaneous
approach, for SAP management, 23
Common bile duct (CBD) stones
classication of, 314
diagnosis of
direct cholangiography, 316–317
elevated liver prole values, 315
endoscopic ultrasound, 316
intraoperative cholangiography,
317, 317f
intraoperative ultrasonography, 317
magnetic resonance
cholangiopancreatography,
315–316, 315f
serum liver function tests, 314
transabdominal ultrasonography,
315
drainage procedures for, 323
endoscopic therapy for, 318–319
etiology of, 314
incidence of, 314
laparoscopic choledochotomy,
321–322, 321f, 322t
laparoscopic therapy for, 319–320
LTCBDE
indications for, 319–320
vs. laparoscopic choledochotomy,
319t
technique of, 320–321, 320f
management, algorithm for, 318, 318f
open CBD exploration, 322
secondary, 314
sonographic criteria for, 148, 150f
transduodenal sphincteroplasty for,
323
Complete cyst resection procedure, for
choledochal cysts, 328, 329
Computed tomography (CT)
for acute pancreatitis, 17–18
bile leak, 227
biliary ductal system, 392–393
choledochal cysts, 328
for chronic pancreatitis, 29
CRLM diagnosis, 178–179
cystic echinococcosis, 207, 208f
gallbladder, 391
gallstone disease, 288, 289f
Index 437
hemangiomas, 213
hepatocellular adenoma, 216, 217f
liver, 388
macrocystic SCA, 51, 52f
MCN with associated mural
calcication, 55f
neuroendocrine carcinoma, 191f, 192f,
193f
pancreas, 394
pancreatic ductal system, 392–393
pancreatic lymphoepithelial cyst, 51,
52f
pancreatic neuroendocrine neoplasms,
67, 68f
for PDAC, 42
of pyogenic liver abscess, 211, 212f
Computed tomography cholangiography
(CTCP), choledochal cysts, 328
Conventional approach, for LT. See Cava-
preserving technique, for LT
Critical view of safety (CVS), 357, 358f,
359
CRLM. See Colorectal liver metastases
(CRL M)
CUSA. See Cavitron Ultrasonic Surgical
Aspirator (CUSA)
Cyst uid analysis, 57–58
Cystic artery, gallbladder anatomy,
266–267
Cystic duct, gallbladder anatomy, 266,
267f
Cystic echinococcosis (CE)
cystectomy of, 210
presentation of, 207
WHO classication of, 207, 209t
Cystic lesions, benign. See Benign cystic
liver lesions
Cystic lesions, of pancreas. See Pancreatic
cystic lesions
Cystic pancreatic neuroendocrine
tumors (pNETs), 53
Cystic plate
gallbladder anatomy, 267–268
plate-sheath system of liver, 265
Cysts
biliary cysts, classication system of,
325, 326f, 327
choledochal cysts (See Choledochal
cysts (CCs))
Cytotoxic chemotherapy, 72
D
Daptomycin, 275
Delayed gastric emptying (DGE), 48
denition of, 103
etiology of, 103–104
incidence of, 103
treatment
NG tube placement, 104, 105
peripherally inserted central
catheter, 104–105
promotility agent, 104
Diagnostic laparoscopy, in PDAC, 44–45
Direct cholangiography, for CBD stones,
316–317
Dissection-only devices
CUSA, 163–164
water-jet dissector, 164
Distal pancreatectomy (DP)
in chronic pancreatitis, 35
description, 83–84
hybrid approach, 86
laparoscopic approach, 86
lateral to medial approach, 84–85
medial to lateral approach, 85
outcomes of, 94
pancreatic adenocarcinoma, 46–47
pancreatic stula incidence, 100
for PDAC resection, 46–47
splenic preservation, 85–86
DNA mismatch repair genes, for
PDAC,41
Doxorubicin-eluting beads, 237
Drug-eluting beads (DEBs)
hepatocellular carcinoma, 237
metastatic colorectal cancer, 241
Ducts of Luschka, 267–268
Duplex and color ow Doppler imaging,
387
E
Echinoccocus granulosus, 207. See also
Cystic echinococcosis (CE)
Echinoccocus multilocularis, 207, 210.
See also Alveolar echinococcosis
(AE)
Electrosurgery
bipolar, 159
complications of, 158–159
limitation of, 158
principle of, 157
Embolization, HCC
bland particle embolization, 237
chemoembolization/drug-eluting
beads, 237
locoregional therapies, 175–176
radioembolization, 237–238
Endocrine graft drainage technique, 382
Endocrine insuciency, incidence of,
109
Endocrine pancreas
cells of, 11, 12t
function of, 11
Endoscopic band ligation, for acute
variceal bleeding, 135
Endoscopic necrosectomy, for SAP
management, 23
Endoscopic retrograde
cholangiopancreatography (ERCP),
397
acute pancreatitis, 402
bile leak, 227
biliary ductal system, 394
CBD stones, 316f
chronic pancreatitis, 401–402
IPMN, 56–57
Index438
Endoscopic retrograde
cholangiopancreatography (ERCP)
(Continued)
jaundice
biliary obstruction and drainage, 400
gastric outlet obstruction, 401
self-expandable metallic stents,
400, 401
pancreatic ductal system, 394
pancreatic stula treatment, 101
PDAC, 43
in periampullary malignancy
distal bile duct stricture, 399, 399f
tissue sampling, 400
postoperative anatomy, 406–407
postoperative complications, 404
preprocedure evaluation, 398–399, 399f
Roux limbs, 407
Endoscopic retrograde pancreatography
(ERP), for chronic pancreatitis, 29
Endoscopic sphincterotomy
for CBD stones, 318–319
for SOD, 306–308, 307t
Endoscopic ultrasound (EUS)
for acute pancreatitis, 17
for CBD stones, 316
for chronic pancreatitis, 29, 30t
ne needle aspiration, 397, 405
mural nodularity within branch-type
IPMN, 56, 57f
palliation of pain, 405–406, 406f
pancreatic neuroendocrine neoplasms,
67, 69f, 70
for pancreatobiliary drainage, 405
for PDAC, 43
preprocedure evaluation, 398–399, 399f
staging of, 405
for tissue sampling, 404–405
Endoscopy
ERCP (See Endoscopic retrograde
cholangiopancreatography (ERCP))
EUS
ne needle aspiration, 397, 405
palliation of pain, 405–406, 406f
for pancreatobiliary drainage, 405
preprocedure evaluation, 398–399,
399f
staging of, 405
for tissue sampling, 404–405
pancreatic uid collections
pseudocyst, 402, 403
transmural drainage, 404
transpapillary drainage, 403, 403f
End-to-end repair, 367, 368
Energy devices, for parenchymal
transection
ablative technologies
microwave energy technology, 163
radiofrequency-assisted
parenchymal transection, 162–163
argon beam coagulator, 162
bipolar vessel-sealing devices, 167t
Enseal, 160–161, 165, 166, 168
LigaSure, 159–160, 166
PlasmaKinetic tissue management
system, 161–162
salient dissecting sealer, 161
dissection-only devices
CUSA, 163–164
water-jet dissector, 164
electrosurgery (See Electrosurgery)
nger fracture technique, 157
ultrasonic cutting and coagulating
surgical device, 164–165
Enseal, 160–161, 165, 166, 168
Entamoeba histolytica infections, 212. See
also Amebic liver abscess
Enteric exocrine drainage technique, 381
Enzyme-linked immunoabsorbent assay
(ELISA), 213
Escherichia coli, 211
Everolimus, 72, 73, 201
Exocrine insuciency, incidence of, 107
Exocrine pancreas
functional unit of, 11
solid epithelial neoplasms of, 39
Extended lymphadenectomy, for
PDAC,47
Extracorporeal shock wave lithotripsy
(ESWL), 402
Extrahepatic bile ducts, 268
Extrahepatic biliary tract injuries, 412
F
False arterial aneurysms. See
Pseudoaneurysms (PSAs)
Familial atypical multiple mole
melanoma (FAMMM) syndrome, 40
Fibrolamellar hepatocellular carcinoma,
215
Fibronectin, 273
Fibrous capsules, liver, 265–266
Fine needle aspiration (FNA), 204
EUS, 397, 405
for SAP management, 21
Finger fracture technique, 157
Fistul a
biliary, 107
complications of pancreas
transplantation, 383, 384
pancreatic, 99–103
Fluid resuscitation, of SAP, 20
Focal nodular hyperplasia (FNH), 148, 215
Frey procedure, 31, 34f
Future liver remnant (FLR), 180–182
assessment and optimization, 117
hepatectomy, 113, 115f
postoperative hepatic insuciency,
228–230
G
Gallbladder
adenocarcinoma, survival for, 342, 343f
anatomy of
agenesis of, 266
cystic artery, 266–267
Index 439
cystic duct, 266, 267f
double gallbladder, 266
hepatocystic triangle, 266
cholescintigraphy, 391–392, 392f
computed tomography, 391
ultrasound, 390–391, 391f
Gallbladder disease
diagnostic imaging in
abdominal x-rays, 286
cholescintigraphy, 287–288, 288f
computerized tomography, 288, 289f
magnetic resonance imaging, 288,
289f
ultrasound, 286–287, 287f
etiology/pathogenesis of
cholecystitis, 284–286
gallstones, 279–284
management of
acute cholecystitis, 290–291
chronic cholecystitis, 288–290, 290f
severe cholecystitis, 291–296
outcomes of, 296, 298
prevalance of, 279
Gallstone ileus, 295f
management of, 295–296
occurrence of, 293
signs and symptoms of, 294
Gallstones
biliary sludge, 279
cholesterol, 279–282, 280f
natural history of, 283–284, 283t
pigment, 281f, 282
prevalence of, 282
risk factors for, 282
Gastric outlet obstruction, treatment
of, 401
Gastrinoma triangle, 65, 66f
Gastrinomas
in MEN1, 71
pancreatic neuroendocrine neoplasms,
65, 66f
H
Hand-assisted technique, 245, 250
Harmonic scalpel, 164–166
HCA. See Hepatocellular adenoma (HCA)
Heat shock protein-32, 273
Heat-sink eect, ablative technique, 239
Hemangiomas
diagnosis of, 213
presentation of, 213
symptoms of, 213
treatment of, 213, 215
Hepatectomy
complications (See Liver surgery,
complications of)
future liver remnant, 113, 115f
laparoscopic liver surgery, 245
liver transplantation, 375, 376f, 377f,
378
Hepatic adenomatosis, 217
Hepatic artery
anomalies of, 268
and liver resections, 257–259, 260f
ramication of
rst-order division, 254, 255f, 256f
second-order branches, 254, 255f,
256f
third-order branches, 254, 255, 255f,
257f
Hepatic injuries
follow-ups, 411
management
complications, 411
operative care, 410–411
postoperative management, 411
preoperative considerations,
409–410
technical tips, 410–411
outcomes, 411
Hepatic metastatic colorectal cancer,
transarterial therapy of, 426–427
Hepatic neuroendocrine metastases, 72
Hepatic resection, 274
hepatocellular carcinoma, 216
NEC, 188
Hepatic tight junctions, 272
Hepatic veins, and liver resections,
262–263, 263f
Hepatitis B, 236
Hepatobiliary host defense mechanism,
272, 272t, 273
Hepatocellular adenoma (HCA)
beta-catenin gene mutations, 216
classication of, 216
diagnosis of, 216
presentation of, 215–216
risk factors for, 215
treatment for, 216–217, 217f
Hepatocellular carcinoma (HCC)
AASLD practice guidelines, 170f
ablation, 238–239
characteristics, 170
chemotherapy, 239
clinical staging systems, 234, 235
diagnosis of, 170, 234
embolization
bland particle embolization, 237
chemoembolization/drug-eluting
beads, 237
radioembolization, 237–238
factors, 233
guidelines, 234
laparoscopic resection for, 246–247
liver transplantation, 235, 373, 374, 374t
locoregional therapies, 174–176
ablation, 175
embolization, 175–176
limitations and outcomes, 175
selection criteria, 176
magnetic resonance imaging,
389f–390f
risk factors, 169
staging systems for, 171, 171f
stereotactic body radiation therapy, 238
surgical resection, 235–236
Index440
Hepatocellular carcinoma (HCC)
(Continued)
surveillance of, 169–170
and transarterial therapy, 426
treatment of
liver resection, 172–173
orthotopic liver transplant, 173–174
transplantation and resection, 171
Hepatofugal ow, 136
Hepatopulmonary syndrome (HPS),
131, 374
Hepatorenal syndrome (HRS), 130–131,
131t, 374
Hereditary breast and ovarian
cancer, 40
Hereditary nonpolyposis colorectal
cancer (HNPCC type II), 40
Hereditary pancreatitis, 40
Hilar bile duct cancer, AJCC staging
system, 335, 337t
Hilar CCA, liver transplant for, 239
Hilar cholangiocarcinoma
MRCP for, 336–337, 339f
preoperative staging system for, 335,
338t
Hilar plate, 264
HO-1 and HO-2 enzymes, 273
Hormonal therapy, for neuroendocrine
carcinoma, 199
Host defense mechanism
bile salts, 273
hepatic tight junctions, 272, 273
hepatobiliary, 272, 272t, 273
immunoglobulin A, 273
Kuper cells, 273
Hydatid (echinococcal) cyst
alveolar echinococcosis, 210–211
cystic echinococcosis, 207–208, 208f, 210
I
Immunoglobulin A (IgA), 273, 274
Immunosuppression, 383
Indocyanine green retention rate at 15
minutes (ICG R15), 115
Infectious cholangitides. See Biliary surger y
Inferior vena cava (IVC) ligament
hepatic veins, 263
right hepatectomy, 250
Inammatory HCA, 216
Insulinomas, 65
International Hepatopancreatobiliary
Association (IHPBA) Consensus
Brisbane (2000) classication for
liver surgery, 111, 114f
International Study Group on Pancreatic
Fistula (ISGPF), 99
Interventional radiology (IR) technique,
for HPB patients
percutaneous biliary intervention (See
Percutaneous biliary intervention,
in biliary obstruction)
percutaneous transhepatic
cholangiography, 415, 417f
postoperative intra-abdominal uid
drainage, 427–429
preoperative portal vein embolization,
422–423
pseudoaneurysms, 429–430
radiofrequency ablation, 423–425, 425f
transarterial therapy, 426–427
transjugular intrahepatic
portosystemic shunt, 419–422
Intra-abdominal uid drainage. See
Postoperative intra-abdominal
uid drainage
Intraductal papillary mucinous
neoplasm (IPMN), 53
cancer antigen (CA) 19-9, 54
CEA level, 57
cytopathology, 57
degree of oncologic risk, 59
ductal connection and multifocality,
55
ERCP, 56–57
EUS, 56, 57f
MRCP, 55
MRI with MRCP, 395, 395f
mucin-laden papillary epithelial
architecture, 53, 53f
PET, 56
preoperative considerations, 59
Intrahepatic cholangiocarcinoma
diagnosis of, 334
incidence of, 333
pathologic features of, 343
phenotypes of, 341
and transarterial therapy, 427
Intraoperative cholangiography (IOC)
in BDI prevention, 359
for CBD stones, 317, 317f
Intraoperative hemorrhage
denition of, 222, 223t, 224
diagnosis and management of, 224
preoperative and intraoperative
considerations, 225–226
Intraoperative laparoscopic ultrasound,
155–156, 156f
Intraoperative ultrasound (IOUS)
basic physics of, 140
of biliary system, 148–149, 149f, 150f
for CBD stones, 317
for colorectal liver metastases, 184
of liver, 148, 388
guidance, 145
systematic approach, 146–147
mechanics of, 140–145
Aloka ultrasound unit, console of,
140, 141f
annotation and storage, 145
biopsy/ablation, 145
depth, 143
Doppler mode, 145
echogenicity, 141
image renement, 143
orientation, 142, 143f
probe types, 142