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Index 441
scanning techniques, 143, 144f
signal transmission, 142
of pancreas, 151–154
pancreatic duct, 152
pancreatic parenchyma, 151, 152f
target lesion, evaluation of, 153–154,
153f, 154f, 155f
vascular relationships, 153
scanning approach, 145t
sound waves, 140
IOUS. See Intraoperative ultrasound
(IOUS)
Irinotecan-eluting beads, 241
Ischemia, of colon/gallbladder, 21
J
Jaundice, ERCP
biliary obstruction and drainage, 400
gastric outlet obstruction, 401
self-expandable metallic stents,
400,401
Jejunojejunostomy leak, 352
K
Klebsiella pneumoniae, 211
Kuper cells, 273, 274
L
β-Lactamase inhibitor, 275
Lanreotide, 72
Laparoscopic approach, to pancreatic
malignancy, 97
Laparoscopic cholecystectomy, for
chronic cholecystitis management,
288–290, 290f
Laparoscopic distal pancreatectomy
(LDP)
for chronic pancreatitis, 37
outcomes of, 94
pancreatic mobilization, 90–91
pancreatic resection, 91
pancreatic stump management and
closure, 91
specimen retrieval, 91
trocar positioning for, 89, 90f
Laparoscopic liver surgery
anatomic resections, 247–251
left lateral sectionectomy, 247, 249,
250f
right hepatectomy, 247–251, 251f
hand-assisted technique, 245
hepatectomy, 245
limitations, 243
oncologic applications
colorectal metastases, 245–246
hepatocellular carcinoma, 246–247
recommendations for, 244
robotic surgery, 248–249
Laparoscopic pancreaticoduoden ectomy,
95t
anastomotic reconstruction, 93
duodenal mobilization, 92
hepatic hilar dissection, 92–93
outcomes of, 94
pancreatic head resection, 93
pancreatic neck dissection, 91–92
specimen removal, 93
trocar positioning for, 91, 92f
Laparoscopic reconstruction
procedure vs. open biliary-enteric
reconstruction, 351t
Laparoscopic transabdominal
debridement, for SAP
management, 24
Laparoscopic transcystic duct bile duct
exploration (LTCBDE)
indications for, 319–320
vs. laparoscopic choledochotomy, 319t
technique of, 320–321, 320f
L DP. See Laparoscopic distal
pancreatectomy (LDP)
Left lateral sectionectomy
laparoscopic liver surgery, 247, 249,
250f
LigaSure, 159–160, 166
Liver
anatomic resections
caudate lobectomy, 255
hemihepatectomies, 258f
prevailing pattern, 260f
sectionectomies, 258f
segmentectomies, 259f
trisectionectomies, 259f
anatomy, 111, 112f, 113f
benign cystic lesions (See Benign cystic
liver lesions)
benign solid lesions of
angiomyolipomas, 218, 220
focal nodular hyperplasia, 215
hemangiomas, 213, 215
hepatic adenomatosis, 217
hepatocellular adenoma, 215–217,
217f
nodular regenerative hyperplasia,
217–218
and bile duct drainage, 259–260, 261f
cancer treatment platforms (See
Multidisciplinary liver tumor
group)
computed tomography, 388
duplex and color ow Doppler imaging,
387
brous capsules and attachments,
265–266
hepatic artery (See Hepatic artery)
and hepatic veins, 262–263, 263f
injury characteristics, chemotherapy-
associated, 117, 117t
intraoperative ultrasound, 148, 388
guidance, 145
systematic approach, 146–147
magnetic resonance imaging, 388,
389f–390f, 390
physiology, 112–115
plate-sheath system, 263–265, 264f, 265f
Index442
Liver (Continued)
portal vein anatomy, 111, 112f
and portal veins, 260, 262, 262f
positron emission tomography
scan,390
preoperative evaluation
complications, risk factors, 116
initial assessment, 116–119
preoperative therapy and downsizing,
119–123
resection
biliary leak mangement after, 362,
364
characteristics, 172
evaluation, future liver remnant
volume, 172–173
outcomes, 173
portal vein embolization, 173
preoperative assessment, liver
function, 172
sonography, 387
ultrasound, 387–388
Liver surgery, complications of
bile leak and organ space infections,
226–228
denition of, 226
diagnosis and management of,
226–227, 228f
preoperative and intraoperative
considerations, 227–228
hepatectomies, 221
intraoperative and postoperative
hemorrhage, 222–226
denition of, 222, 223t, 224
diagnosis and management of, 224
preoperative and intraoperative
considerations, 225–226
long-term benets, 222
outcomes/follow-up, 230–231
PHI and liver-related mortality
denition of, 228–229
diagnosis and management of, 229
preoperative and intraoperative
considerations, 229–230
predictors of, 221, 222
Liver transplantation (LT)
biliary leak mangement after, 364
complications of
bacterial and fungal infections, 380
biliary complications, 378, 379
HCC and PTLD, 380
immunosuppressive drugs, 379, 380
primary nonfunction, 378
thrombosis, 378
contraindications for, 373, 374
donors expansion, 373
factors, 373
with hepatocellular carcinoma, 373,
374, 374t
hepatopulmonary syndrome, 374
hepatorenal syndrome, 374
indications for, 373, 374t
neuroendocrine carcinoma, 196, 197f
procedure/technique
graft implantation, 378, 379f
organ procurement operation, 375,
376f
preparation of graft, 375
recipient hepatectomy, 375, 377f, 378
Liver-directed therapies (LDTs)
for HCC, 235, 374
neuroendocrine carcinoma, 187
Liver-related mortality
denition of, 228–229
diagnosis and management of, 229
preoperative and intraoperative
considerations, 229–230
Local resection of pancreatic
head with longitudinal
pancreaticojejunostomy (LR-LPJ),
31, 34f
Locally advanced tumor, 44
Long common channel theory, 325
Low CVP anesthesia concept, for liver
resections, 225
LT. See Liver transplantation (LT)
Lymphatic drainage, of pancreas, 9, 10f
Lymphoepithelial cysts, 51, 52f
M
Magnetic resonance
cholangiopancreatography (MRCP)
biliary ductal system, 393–394, 394f
for CBD stones, 315–316, 315f
choledochal cysts, 328
for hilar cholangiocarcinoma, 336–337,
339f
intraductal papillary mucinous
neoplasm, 55
pancreas, 394–395, 395f, 396f
for pancreatic cysts, 55, 56f
pancreatic ductal system, 393–394,
394f
Magnetic resonance imaging (MRI)
for acute pancreatitis, 18, 18f
CRLM diagnosis, 179, 180
focal nodular hyperplasia, 215
gallstone disease, 288, 289f
hemangiomas, 213
hepatocellular adenoma, 216
hepatocellular carcinoma, 389f–390f
liver, 388, 389f–390f, 390
pancreas, 394–395, 395f, 396f
pancreatic neuroendocrine neoplasms,
67, 69f
for PDAC, 42
Magnetic resonance pancreatography
(MRP), for chronic pancreatitis, 29
Main duct of Wirsung, 3, 4, 5f
Major biliary ductal injury, 355
Medical College of Wisconsin CT-based
clinical staging, of pancreatic
cancer, 76, 77t
MEN 1. See Multiple neuroendocrine
neoplasia type 1 (MEN 1)
Mesenteric drainage technique, 382, 383
Index 443
Metastatic colorectal cancer
ablation, 241
chemotherapy, 240
drug-eluting beads, 241
stereotactic body radiation therapy, 241
surgical resection for, 240–241
Yttrium-90, 241
Metastatic tumor, 44
Metronidazole, 213
Microwave ablation, 184, 239
Microwave scalpel, 163
Minimally invasive biliary surgery
complications of
biliary stula/stricture, 351, 352
hernias, 352
jejunojejunostomy leak, 352
laparoscopic vs. open biliary-enteric
reconstruction, 351t
indications for, 346, 347, 347t
outcomes/follow-up, 351t, 352
postoperative management, 351–352,
351t
preoperative considerations
cholangiography and cross-sectional
imaging, 346
history taking and examination,
345, 346
instrumentation, 346
patient variables, 345
Roux-en-Y hepaticojejunostomy
biliary-enteric anastomosis,
350–351, 350f
mobilization, 348–350, 349f
patient position, 347
port site placement for, 347, 348f
side-to-side jejunojejunostomy,
347, 348
Minimally invasive PD (MIPD), for
PDAC, 48
Minimally invasive surgery (MIS), for
pancreas
contraindications for, 89
indications for, 89
laparoscopic distal pancreatectomy,
89–91, 90f
laparoscopic
pancreaticoduodenectomy, 91–93
outcomes of, 94–97
postoperative management of, 93
Minnesota tubes, 135
Minor bile leaks, 355
Mirizzi syndrome, 296, 297f
Model for end-stage liver disease (MELD)
score, 421
for cirrhosis, 113, 138
liver disease severity, 130
liver transplantation, 373
Modied Milwaukee classication, for
Sphincter of Oddi dysfunction,
300, 301t
Modied pancreatic classication
system, for Sphincter of Oddi
dysfunction, 300, 301t
modied RECIST criteria (mRECIST),
238
Monopolar electrocautery, 157, 158
Mucinous cystic neoplasms (MCNs), 53
Multidetector-row CT (MDCT),
388, 394
for HCC, 170
for PDAC, 42
Multidisciplinary liver tumor group
HCC (See Hepatocellular carcinoma
(HCC))
metastatic colorectal cancer
ablation, 241
chemotherapy, 240
drug-eluting beads, 241
stereotactic body radiation therapy,
241
surgical resection for, 240–241
Yttrium-90, 241
Multiple cystic dilations, 326f, 327
Multiple neuroendocrine neoplasia type
1 (MEN 1), 62, 71
N
NEC. See Neuroendocrine carcinoma
(NEC)
Necrosis, patterns of, 22, 23f
Necrotic debris, endoscopy, 404
Necrotizing pancreatitis (NP)
endoscopic necrosectomy, 23
intervention in, 21
antibiotic treatment, 22
goals of, 22
patient selection, 22
percutaneous drainage, 23
Neoadjuvant therapy, for PDAC, 45–46
Neoplasms, pancreatic neuroendocrine.
See Pancreatic neuroendocrine
neoplasms
Neuroendocrine carcinoma (NEC),
201–202
ablative therapy, 198
chemotherapy, 199–201
computed tomography, 191f, 192f, 193f
diagnostic evaluation of, 188
ne needle aspiration/core biopsy,
190
grades of, 190–191
tumor site of origin, 189
hepatic metastases from, 187–188
hormonal therapy, 199
liver transplantation, 196, 197f
palliative resection, 194–196
potentially curative resection of,
193–194
radiation therapy, 199
radiolabeled somatostatin receptor
scintigraphy, 191
transarterial therapies, 198–199
treatment follow-up evaluation, 201
Neuroendocrine tumors, transarterial
therapy of, 427
Nifedipine, 305, 306
Index444
Nodular regenerative hyperplasia (NRH)
diagnosis of, 218
presentation of, 217–218
treatment of, 218
Nonalcoholic fatty liver disease/
nonalcoholic steatohepatitis
(NASH), for HCC, 169, 233, 236
Nonanatomic wedge resections. See
Laparoscopic liver surgery
Noncholestatic liver disease, 373, 374t
Nonselective shunts, 136–137
N P. See Necrotizing pancreatitis (NP)
Nutrition, for SAP management, 20–21
O
Octreotide, 70, 199
for acute variceal bleeding, 135
for pancreatic neuroendocrine
neoplasms management, 72
Oncogenes, for PDAC, 40–41
Open biliary-enteric reconstruction vs.
laparoscopic reconstruction, 351t
Open pancreatic debridement, for SAP
management, 24–25
Organ space infections
denition of, 226
diagnosis and management of,
226–227, 228f
preoperative and intraoperative
considerations, 227–228
Orthotopic liver transplant (OLT)
downstaging, 174
HCC patient management, on waiting
list, 174
Milan criteria, 173–174
Oven eect, ablative technique, 239
P
Packed red blood cells (PRBC), 224
PAIR (puncture, aspiration, injection,
reaspiration) technique, 210
Palliative resection, in neuroendocrine
carcinoma, 194–196
Pancreas
anatomy of, 2–3
arterial blood supply of, 5–7, 6f
body and tail of, 3
computed tomography, 394
embryology, 3–5
endocrine
cells of, 11, 12t
function of, 11
exocrine pancreas, functional unit
of, 11
uid collections
pseudocyst, 402, 403
transmural drainage, 404
transpapillary drainage, 403, 403f
head region, 2
innervation of, 9–10
intraoperative ultrasound, 151–154
pancreatic duct, 152
pancreatic parenchyma, 151, 152f
target lesion, evaluation of, 153–154,
153f, 154f, 155f
vascular relationships, 153
lymphatic drainage of, 9, 10f
MRI with MRCP, 394–395, 395f, 396f
neck of, 2–3
PET scan, 395–396
physiology of, 10–13
ultrasound, 394
uncinate process, 2
venous blood supply, 7–9, 8f
Pancreas transplant alone (PTA), 381
Pancreas transplantation
complications of
abscess/stula, 383, 384
postoperative hemorrhage, 383
small bowel obstruction, 384, 385
thrombosis, 383
contraindications for, 381
immunosuppression, 383
indications for, 380–381
outcomes, 385–386
surgical technique, 381–383
bladder drainage, 381, 382
endocrine graft drainage, 382
enteric exocrine drainage, 381
mesenteric drainage, 382, 383
tension-free enteric anastomosis,
382, 382f
Pancreatectomy
central, 87
distal
description, 83–84
hybrid approach, 86
laparoscopic approach, 86
lateral to medial approach, 84–85
medial to lateral approach, 85
pancreatic stula incidence, 100
splenic preservation, 85–86
total, 86–87
Pancreatic cystic lesions
benign, 51
diagnosis of
carcinoembryonic antigen level, 57
clinical history in, 54
cyst uid analysis, 57–58
cytopathology, 57
DNA and biochemical markers, 58t
physical examination in, 54
radiologic, 54–57
serologic, 54
symptoms of, 54
IPMN (See Intraductal papillary
mucinous neoplasm (IPMN))
management of
complications, 60
intraoperative considerations, 59–60
operative indications, 58–59
postoperative management, 60
preoperative considerations, 59
outcomes and follow-up, 60–61
premalignant/malignant cysts, 52–54
Index 445
Pancreatic duct anatomy, 3–5, 5f
Pancreatic ductal adenocarcinoma
(PDAC)
classical vs. pylorus-preserving PD, 47
diagnosis of, 41–43
CA 19-9, 41–42
clinical presentation, 41
imaging modalities, 42–43
laboratory analysis, 41–42
serum markers, 42
tissue markers, 42
DNA mismatch repair genes, 41
etiology of, 39–41
gemcitabine, 49
management of, 43–46
assessing surgical resectability, 43–44
diagnostic laparoscopy, 44–45
neoadjuvant therapy, 45–46
preoperative biliary drainage, 45
molecular genetics, 40–41
oncogenes, 40–41
outcomes and follow-up, 49–50
pathology of, 39
risk factors for
acquired/environmental factors, 40
demographic factors, 39–40
host factors, 40
surgical resection, 39
adjuvant therapy, 48–49
classical vs. pylorus-preserving
PD, 47
distal pancreatectomy, 46–47
extended lymphadenectomy, 47
margin status, 48
minimally invasive PD, 48
pancreaticoduodenectomy, 46
postoperative complications, 48
surgical palliation, 47
vascular resection/reconstruction,
47–48
tumor suppressor genes, 40
variants of, 39
vascular resection/reconstruction,
47–48
Pancreatic ductal system
computed tomography, 392–393
endoscopic retrograde
cholangiopancreatography, 394
magnetic resonance
cholangiopancreatography,
393–394, 394f
percutaneous transhepatic
cholangiography, 394
ultrasound, 392
Pancreatic stula
denition of, 99
incidence of, 100
parameters for, 99, 100t
risk factors for, 99–100
treatment of
drainage, 101
endoscopic retrograde
cholangiopancreatography, 101
goals of, 100
nutritional support, 103
percutaneous drain management,
102f
somatostatin, 101
tubogram, 103f
Pancreatic injuries
complications, 414
operative care, 413
postoperative management, 414
preoperative considerations, 413
technical tips, 413
Pancreatic intraepithelial neoplasia
(PanIN), 39
Pancreatic necrosis, 19f
Pancreatic neuroendocrine neoplasms
AJCC Classication System, 74t
diagnosis of
clinical presentation, 62, 63t–64t,
65–67, 66f
imaging and localizing studies, 67,
68f, 69f, 70
etiology of, 62
gastrinomas, 65
glucagonomas, 65
incidence of, 62
insulinomas, 65
management of
localized disease, 70–71
MEN1, gastrinoma arising, 71
metastatic disease, 71–72
outcomes, 73, 73t, 74t, 75t
systemic therapy, 72–73
nonfunctioning, 67
somatostatinomas, 67
VIPomas, 66
WHO classication, 75t
Pancreatic surgery
complications
biliary stula, 107
delayed gastric emptying, 103–105
exocrine and endocrine insuciency,
107, 109
pancreatic stula, 99–103
postoperative hemorrhage, 105–107,
106f, 108f
morbidity rate, 99
technical aspects
central pancreatectomy, 87
distal pancreatectomy, 83–86
pancreaticoduodenectomy, 76–83
preoperative considerations, 76
total pancreatectomy, 86–87
Pancreatic tail mucinous cystic
neoplasm, laparoscopic IOUS of,
154, 155f
Pancreaticobiliary maljunction (PBM), 3
Pancreaticoduodenectomy
biliary anastomosis, 82
closure procedure, 82
description, 76
gastrojejunostomy, end-to-side, 82
pancreatic anastomosis, 81–82
Index446
Pancreaticoduodenectomy (Continued)
PDAC resection, 46
pylorus preservation, 82
surgical resection steps, 76–80
infrapancreatic SMV isolation, 76, 77
Kocher maneuver, 78
ligament of Treitz, 78
portal dissection, 78, 79f
sharp dissection, SMA margin,
80,81f
terminal branches ligation, 78
traction sutures, 78–79
uncinate process removal, 79, 80f
venous resection, 83
Pancreatitis, ERCP role in
acute, 402
chronic, 401–402
Pancreatobiliary drainage, EUS for, 405
Pancreatoblastomas, 39
Pancreatoduodenectomy (PD), for
chronic pancreatitis, 31
Parenchymal transection, for energy
devices. See Energy devices, for
parenchymal transection
PathFinder TG test, 57–58
PDAC. See Pancreatic ductal
adenocarcinoma (PDAC)
Pedicle clamping, 168
Percutaneous biliary intervention, in
biliary obstruction
immediate and delayed complications
of, 419
indications and contraindications to,
415, 416t
outcomes/follow-up of, 419
postprocedural management of, 418
surgical procedure, 415–418
Percutaneous drainage
iatrogenic bile duct injuries, 419
of postoperative abdominal uid
collection, 427
for pyogenic liver abscess, 211, 212
for SAP management, 23, 24
Percutaneous transhepatic
cholangiography (PTC), 415, 417f
bile leak, 227
biliary ductal system, 394
choledochal cysts, 328
pancreatic ductal system, 394
Periampullary malignancy, ERCP role in
distal bile duct stricture, 399, 399f
tissue sampling, 400
Peri-pancreatic inammatory
collections, IOUS, 154, 155f
Peripherally inserted central catheter
(PICC), 104, 105
Peutz-Jeghers syndrome, 40
Piggyback technique, for LT, 375, 377f,
378
PlasmaKinetic tissue management
system, 161–162
Plate-sheath system of liver, 263–265,
264f, 265f
Pneumoperitoneum, laparoscopic
resection for HCC, 246
Polysomy, 335
Portal hypertension
ascites, 132
denition of, 126
esophageal varices, 134
laparoscopic resection for HCC, 246
liver transplantation, 137–138
preoperative considerations of, 138
spontaneous bacterial peritonitis, 134
venous collaterals, 127, 128f
Portal vein embolization (PVE), 181–182,
181f
postoperative hepatic insuciency, 230
preoperative (See Preoperative portal
vein embolization)
Portal veins and liver resections, 260,
262, 262f
Portosystemic shunts
nonselective shunts, 136–137
partial shunts, 137
selective shunt, 137
Positron emission tomography (PET)
CRLM diagnosis, 179
of liver, 390
of pancreas, 395–396
for pancreatic cysts, 56
for PDAC, 43
Posthepatectomy biloma, 228
Posthepatectomy complications. See also
Liver surgery, complications of
case studies, 221, 222t
denitions of, 223t
Posthepatectomy hemorrhage (PHH),
denition of, 222, 223t, 224
Posthepatectomy liver failure. See
Postoperative hepatic insuciency
(PHI)
Postoperative hemorrhage
complications of pancreas
transplantation, 383
liver surgery, complications of
denition of, 222, 223t, 224
diagnosis and management of, 224
preoperative and intraoperative
considerations, 225–226
postpancreatectomy, 105–107, 106f, 108f
Postoperative hepatic insuciency (PHI)
denition of, 228–229
diagnosis and management of, 229
phases of, 221
preoperative and intraoperative
considerations, 229–230
Postoperative intra-abdominal uid
drainage, 427–429
Postoperative pancreatic stula (POPF),
48
grading system for, 31, 35t
Postpancreatectomy
denition, 105
incidence of, 105
treatment, 105–107
Index 447
Potentially curative resection, 193–194
Preoperative biliary drainage (PBD), for
obstructive jaundice, 45
Preoperative portal vein embolization,
422–423, 423f
Primary CBD stones, 314
Primary nonfunction (PNF), 378
Primary sclerosing cholangitis (PSC), 333
Prophylactic cholecystectomy,
indications for, 283t, 284
Pseudoaneurysms (PSAs)
computed tomography angiography,
429f, 430
magnetic resonance angiography,
429f, 430
management of, 430
prevalence of, 429
Pseudocyst, 402–404
Pylorus-preserving
pancreatoduodenectomy (PPPD),
31, 104
Pyogenic liver abscesses (PLA), 211–212,
212f
R
Radiation therapy, for neuroendocrine
carcinoma, 199
Radical antegrade modular
pancreatosplenectomy (RAMPS)
procedure, 47
Radioembolization, 237–238, 426–427
Radiofrequency ablation (RFA)
colorectal liver metastases, 184
complications of, 424
contraindications of, 424
goal of, 423
hepatocellular carcinoma, 216
indications of, 424
postoperative care, 425, 425f
preoperative workup, 424
Radiofrequency-assisted parenchymal
transection (RF-PT), 162–163, 166
Radiolabeled somatostatin receptor
scintigraphy, 191
Ranson’s criteria, for AP severity, 15, 16t
Resectable tumor, 43
Retroperitoneal approach, for SAP
management, 24
Revised Atlanta criteria, for AP severity,
16, 17t
RFA. See Radiofrequency ablation (RFA)
Right hepatectomy, 247–251, 251f
Ringer solution, 20
Robotic liver surgery, 248–249
Robotic-assisted laparoscopic pancreatic
resection, 94, 96
advantages and disadvantages of, 96t
Rome III classication system, for
Sphincter of Oddi dysfunction,
302, 303t
Roux limbs
biliary–enteric anastomosis, 350, 351
biliary–enteric reconstruction, 347
endoscopic retrograde
cholangiopancreatography, 407
side-to-side jejunojejunostomy, 348
Roux-en-Y choledochojejunostomy, 323,
364, 404
Roux-en-Y hepaticojejunostomy
for BDI repair, 367, 368f
minimally invasive biliary surgery
biliary-enteric anastomosis,
350–351, 350f
mobilization, 348–350, 349f
outcomes/follow-up, 351t, 352
patient position, 347
port site placement for, 347, 348f
side-to-side jejunojejunostomy,
347, 348
Roux-en-Y jejunal limb, 31, 32f
Roux-en-Y jejunal loop, 34f, 36f
S
S AP. See Severe acute pancreatitis (SAP)
Sclerotherapy, for acute variceal
bleeding, 135
Secondary common bile duct
stones,314
Secondary malignancies, in liver. See
Metastatic colorectal cancer
Sectionectomies
anatomic resections of liver, 258f
left lateral sectionectomy, 247, 250f
Segmentectomies, 259f
Selective arterial stimulation, 70
Selective internal radiation therapy
(SIRT), 198–199
Selective shunts, 137
Self-expandable metallic stents (SEMS),
400, 401
Sengstaken-Blakemore tubes, 135
Serous cystadenomas (SCA), 51, 52f
Serous cystic neoplasms (SCNs), 51, 52f
Serum C-reactive protein (CRP), for AP
severity, 15–16
Severe acute pancreatitis (SAP). See also
Acute pancreatitis (AP)
management of
antibiotics for, 20
bleeding, 21
combined endoscopic and
percutaneous approach, 23
endoscopic necrosectomy, 23
ERCP indications, 21
ne needle aspiration, 21
uid resuscitation of, 20
ischemia, of colon/gallbladder, 21
laparoscopic transabdominal
debridement, 24
necrotizing pancreatitis (See
Necrotizing pancreatitis (NP))
nutritional support, 20–21
open pancreatic debridement, 24–25
percutaneous drainage, 23
retroperitoneal approach, 24
transgastric debridement, 24
Index448
Severe acute pancreatitis (SAP)
(Continued)
venous thromboembolism, 21
volume resuscitation/ICU
monitoring of, 20
natural history of, 14, 19–20
Side-to-side jejunojejunostomy, 347, 348
Simple cyst excision procedure,
choledochal cysts, 329
Simple pancreatic cysts, 51
Small bowel obstruction (SBO), 384–385
SOD. See Sphincter of Oddi dysfunction
(SOD)
Solid and cystic pseudopapillary
neoplasms (SPNs), 53–54
Solid epithelial neoplasms, of exocrine
pancreas, 39
Solid lesions, benign. See Benign solid
liver lesions
Somatostatin, 199
for pancreatic stula treatment, 101
for pancreatic neuroendocrine
neoplasms management, 72–73
somatostatin receptor scintigraphy,
68, 70
Somatostatinomas, 67
Sonography. See also Ultrasound (US)
for liver evaluation, 387
for pancreatic evaluation, 394
Sorafenib, for HCC, 176, 239
Space of Disse, 126
Sphincter of Oddi dysfunction (SOD)
clinical presentation of, 302–303
complications and prevention of, 310
description of, 300
diagnostic workup and treatment of,
310f
dierential diagnosis of, 303–305
epidemiology of, 300–301
modied Milwaukee classication for,
300, 301t
modied pancreatic classication
system for, 300, 301t
pathogenesis and pathology of, 301–302
Rome III classication system for,
302, 303t
SOM performance, 304–305
therapeutic approach for
balloon dilation and stenting,
308–309
Botulinum toxin injection, 309
endoscopic sphincterotomy,
306–308, 307t
medical therapy for, 305–306
post biliary sphincterotomy, failure
of, 309–310
surgical therapy for, 306
transduodenal biliary sphincteroplasty,
with transampullary septoplasty,
306
Standard bicaval anastomosis, for LT,
375, 377f, 378
Steatotic HCA, 216
Stereotactic body radiation therapy
(SBRT)
hepatocellular carcinoma, 238
metastatic colorectal cancer, 241
Stewart-Way classication, of common
bile duct injury, 357t
Strasberg classication, of biliary leak,
354, 356f
Sunitinib, for pancreatic neuroendocrine
neoplasms, 72, 73
Surgical shunt creation, 136–137
Symptomatic gallstones, 283
Synchronous carcinoid metastasis, 194,
194f–195f
Systemic inammatory response
syndrome, 226
Systemic therapy, for pancreatic
neuroendocrine neoplasms, 72–73
T
99
Technetium HIDA scan
bile leaks, 360, 361
choledochal cysts, 328
eraSphere™ glass microspheres, 237
TIPS. See Transjugular intrahepatic
portosystemic shunt (TIPS)
TissueLink, 161
Total laparoscopic
pancreaticoduodenectomy (TLPD),
94, 95t
Total pancreatectomy, 86–87
Total pancreatectomy with islet
autotransplantation (TP-IAT)
for chronic pancreatitis, 36–37
Transabdominal ultrasonography (TAUS)
for acute pancreatitis, 16–17, 17f
for CBD stones, 315
for PDAC, 42
Transarterial chemoembolization
(TACE), 198, 199
Transarterial embolization (TAE),
198–199, 216
Transarterial therapy, 426–427
bland embolization, 426
chemoembolization, 426
of hepatic metastatic colorectal cancer,
426–427
and hepatocellular carcinoma, 426
and intrahepatic cholangiocarcinoma,
427
neuroendocrine carcinoma, 198–199
of neuroendocrine tumors, 427
postoperative care, 427
preprocedure workup, 427
radioembolization, 426
Transduodenal sphincteroplasty, for CBD
stones, 323
Transgastric debridement, for SAP
management, 24
Transgastric endoscopic debridement,
of NP, 23
Transjugular intrahepatic portosystemic
shunt (TIPS)
Index 449
for acute variceal bleeding, 136
indications and contraindications to,
421, 421t
in-shunt stenosis, 137
model for end-stage liver disease score,
421
postoperative care of, 422
preoperative evaluation of, 422
schematic illustration of, 419, 420f
success rates of, 421
Transmural drainage, 404
Transpapillary drainage, 403, 403f
Trauma, biliary leak mangement after,
364–365
Trisomy 7, 335
Tumor suppressor genes, 40
Tumor-node-metastasis (TNM) schema,
73, 74t
Two-stage hepatectomy, 182, 182f
U
Ultrasound (US)
acute pancreatitis, 16–17, 17f
biliary ductal system, 392
choledochal cysts, 327, 328
cystic echinococcosis, 207, 208f
gallbladder, 390–391, 391f
gallbladder disease, 286–287, 287f
hemangiomas, 213
liver, 387–388
pancreas, 394
pancreatic ductal system, 392
V
Vancomycin, 275
Vardenal (Levitra), 305
Vasoactive intestinal polypeptide (VIP),
66–67
Vasopressin administration, for acute
variceal bleeding, 135
Venous blood supply, pancreas,
7–9, 8f
Venous resection, 83
Venous sampling, 70
Venous thromboembolism, 21
Verner-Morrison syndrome of
VIPomas,67
VIPomas, 66, 67
W
Washout phenomenon, 388
Water-Jet dissector, 164
WDHA syndrome. See Verner-Morrison
syndrome of VIPomas
Wedge resections. See Laparoscopic liver
surgery
Whipple procedure. See
Pancreaticoduodenectomy
Whipple triad, insulinomas
diagnosis,65
Whittaker test, 418
World Health Organization (WHO)
classication
dierentiation of cysts, 207, 209t
of pancreatic neuroendocrine
neoplasms, 73, 75t
Y
Yttrium-90 (Y90)
advantages of, 237
metastatic colorectal cancer, 241
microspheres, 240
Z
Zollinger-Ellison syndrome, 65