Diseases of the liver and biliary tree vary from common disorders, such as benign liver lesions, to complex diseases requiring highly specialized surgeries. Liver surgery has evolved significantly over the last two decades, with dramatic decreases in perioperative morbidity and mortality. Simultaneously, improvements in imaging and systemic therapy and techniques to induce liver hypertrophy have changed the multidisciplinary management of liver diseases, allowing surgery to be applied in an ever-increasing portion of patients with diseases of the liver and the biliary tree. Finally, the addition of minimally invasive surgery continues to change the field, with continued movement towards better patient outcomes.
This manual is a presentation of the current state of hepatobiliary surgery. Chapters in this text address the surgeon's role in the management of both benign and malignant diseases for the liver including biliary diseases, highlighting the modern approach to these disease processes and indications for surgery. Other chapters focus more specifically on the technical approach to operations involving the liver and biliary tree. Authors are experts in the field of hepatobiliary surgery, both in the overall management and technical conduct of selected operations. Each chapter includes a brief review of current literature relevant to the selected topic and include extensive illustrations and links to selected videos.
Gallbladder Malignancy.- Pre-Malignant Gallbladder Lesions.- Intraoperative Management of Incidental Neoplastic Findings (Gallbladder).- Intraductal Papillary Neoplasm of the Bile Duct (IPNB).- Intrahepatic Cholangiocarcinoma.- Extrahepatic Cholangiocarcinoma.- Hepatic Pre-Malignant Lesions.- Hepatocellular Carcinoma.- Surgical Management of Colorectal Liver Metastases.- Neuroendocrine Liver Metastasis.- Non-CR, Non-NE Liver Metastases.- Positions and Access.- Instrumentation and Approaches for Parenchymal Transection.- Robotic Approaches to Hepatic Transection.- Hemostasis and Basics of Hemorrhage Control.- Assessment of the Hepatic Remnant and Preoperative Imaging.- Hilar Dissection.- Liver Mobilization and Ultrasound.- Minimally Invasive Pringle Maneuvers.- Intraoperative Cholangiography, Choledochoscopy, and Fluorescent Cholangiography.- Liver Core Needle Biopsies and Wedge Resection.- Inferior Partial Hepatectomy and Superior Partial Hepatectomy.- Anatomic Metastasectomy/Segmentectomy and Left Lateral Sectionectomy.- Open Right and Left Hepatectomy.- Major Hepatectomy: MIS Left Hepatectomy and Right Hepatectomy.- Right Posterior Sectionectomy, Anterior Sectionectomy, and Central Hepatectomy.- Extended Hepatectomy.- Bile Duct Resection and Reconstruction.- Radical Cholecystectomy.- Portal Lymphadenectomy: Technical Pearls and Pitfalls.- Surgical Microwave Ablation of the Liver.- Non-Thermal Ablation.- Hepatic Artery Infusion Pump: Open and Robotic Techniques for Placement.
