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_1841_Библиотеки_им_академика_М_И_Перельмана.pdf
Symptomatic
Asymptomatic
Mass effect
• Resection if feasible.
• If not, gastric bypass
Capsular pain
Regional blockade, surgery
rarely necessary
Embolization/surgery
Bleeding
Observe
Haemangioma
Adenoma
FNH
Other
Observation
No treatment unless
symptoms develop
Stop oral contraceptives
Large
Resection if
patient fit
Multiple Observe
Consider ablation
Awkward
position
Percutaneous
drainage
Consider
secondary
surgery
Surgery only for very large
lesions or high output failure
Necrosis/
infection
Liver tumour benign
on investigation/
biopsy
Management of a benign liver tumour. See page 146.
Operative Solutions
in Hepatobiliary
and Pancreatic
Surgery
Front cover
C.1480, Aztec image of Mictlantecuhtli, the God of the dead. From his stomach
hangs a huge liver, the repository of the human spirit in Aztec culture. Since
ancient times, the liver has been associated with death and Mictlan, the lowest
part of the universe, damp and cold, where Mictlantecuhtli lived.
176cm in height, made of fired clay, stucco and paint, and housed in Museo
del Pemplo Mayor, Mexico City.
1
Operative Solutions
in Hepatobiliary
and Pancreatic
Surgery
Ashley R. Dennison
Consultant Hepatobiliary Surgeon
Leicester General Hospital
Leicester, U.K.
Guy J. Maddern
R.P. Jepson Professor of Surgery
The University of Adelaide
Adelaide, Australia
Illustrations by
Vicky Dennison
1
Great Clarendon Street, Oxford OX2 6DP
Oxford University Press is a department of the University of Oxford.
It furthers the University’s objective of excellence in research, scholarship,
and education by publishing worldwide in
Oxford New York
Auckland Cape Town Dar es Salaam Hong Kong Karachi
Kuala Lumpur Madrid Melbourne Mexico City Nairobi
New Delhi Shanghai Taipei Toronto
With offi ces in
Argentina Austria Brazil Chile Czech Republic France Greece
Guatemala Hungary Italy Japan Poland Portugal Singapore
South Korea Switzerland Thailand Turkey Ukraine Vietnam
Oxford is a registered trade mark of Oxford University Press
in the UK and in certain other countries
Published in the United States
by Oxford University Press Inc., New York
© Oxford University Press, 2010
The moral rights of the author have been asserted
Database right Oxford University Press (maker)
First published 2010
All rights reserved. No part of this publication may be reproduced,
stored in a retrieval system, or transmitted, in any form or by any means,
without the prior permission in writing of Oxford University Press,
or as expressly permitted by law, or under terms agreed with the appropriate
reprographics rights organization. Enquiries concerning reproduction
outside the scope of the above should be sent to the Rights Department,
Oxford University Press, at the address above
You must not circulate this book in any other binding or cover
and you must impose the same condition on any acquirer
British Library Cataloguing in Publication Data
Data available
Library of Congress Cataloging in Publication Data
Data available
Typeset in Minion by Glyph International Bangalore, India
Printed in Great Britain
on acid-free paper by
MPG Biddles Ltd
ISBN 978–0–19–958417–8
10 9 8 7 6 5 4 3 2 1
Oxford University Press makes no representation, express or implied, that the drug
dosages in this book are correct. Readers must therefore always check the product
information and clinical procedures with the most up-to-date published product
information and data sheets provided by the manufacturers and the most recent codes of
conduct and safety regulations. The authors and the publishers do not accept responsibility
or legal liability for any errors in the text or for the misuse or misapplication of material in
this work. Except where otherwise stated, drug dosages and recommendations are for the
non-pregnant adult who is not breastfeeding.
This book is dedicated to the wisdom of our surgical
teachers and made possible by our families
This page intentionally left blank
Foreword
It is a great pleasure to write a foreword to this book, written by two accom-
plished surgeons who worked with me during my tenure as Professor of
Surgery at The University of Bern, Switzerland.
Hepatobiliary and pancreatic surgery has rapidly evolved into a specialty but
there are many general surgeons who, for geographical reasons, must manage
acute problems and may have great difficulty in referring non urgent cases to
suitable specialist centres. In addition, many young surgeons who have been
trained in specialist centres have not have sufficient experience to allow them
complete confidence in taking up appointments to consultant posts and still
require help with many of the problems that arise in the day to day practice
of a complex specialty. This book, which is clearly illustrated with clean line
drawings and a straight forward text, allows the reader to follow a precise step-
wise approach to the diagnosis, determination of resectability and operative
procedures involved. There are a large number of flow charts allowing the
reader to trace pathways of management for a variety of conditions and, inter-
estingly, the flow charts are designed to allow the reader to modify the approach
and adapt their own practice to the expertise available in this book. Such flow
charts can be of limited value but this book provides a clearly written text
which helps the reader navigate the often complicated pathways illustrated.
There is an interesting omission of any radiologic pictures and, indeed, this
book is heavy on the management of diseases and is more of an atlas rather
than a textbook. Nevertheless, it succeeds admirably in helping determine an
approach to complex operative procedures and the perioperative difficulties
that may be encountered.
This book will prove to be a useful guide to the senior trainee and the freshly
appointed specialist, offering a management approach to a range of problems
in a clear and informative style. It will be a frequently consulted text on the
bookshelf and a friendly companion to the surgeon confronted by the difficult
problems that arise in any hepatobiliary and pancreatic practice.
Professor Leslie H. Blumgart, MD, FRCS, FACS
Memorial Sloan-Kettering Cancer Center,
New York, U.S.A.
This page intentionally left blank