Table of Contents
Master Techniques in Surgery : Hepatobiliary and Pancreatic Surgery
Edited by:
Keith D. Lillemoe, MD
W.G. Austen Professor
Harvard Medical School
Chief of Surgery
Massachusetts General Hospital
Boston, Massachusetts
William R. Jarnagin, MD
Chief, Hepatopancreatobiliary Service
Leslie H. Blumgart Chair
Department of Surgery
Memorial Sloan-Kettering Cancer Center
Professor of Surgery
Weill Medical College of Cornell University
New York, New York
Series Editor
Josef E. Fischer, MD
Distinguished William V. McDermott
Professor of Surgery
Harvard Medical School
Chair, Department of Surgery, Emeritus
Beth Israel Deaconess Medical Center
Chair, Department of Surgery, Emeritus
University of Cincinnati College of Medicine
Boston, Massachusetts
Illustrations by: Anne Rains, Arains Illustration, Inc.
Body Scientific International, LLC.
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Library of Congress Cataloging-in-Publication Data
Names: Lillemoe, Keith D., editor. | Jarnagin, William R. (Surgeon), editor.
Title: Hepatobiliary and pancreatic surgery / edited by Keith D. Lillemoe, William R. Jarnagin.
Other titles: Hepatobiliary and pancreatic surgery (Lillemoe) | Master techniques in surgery.
Description: Second edition. | Philadelphia : Wolters Kluwer, [2020] | Series: Master techniques in surgery | Includes bibliographical references and index.
Identifiers: LCCN 2019015650 | ISBN 9781496385574
Subjects: | MESH: Liver Diseasessurgery | Pancreatic Diseasessurgery | Biliary Tract Diseasessurgery | Digestive System Surgical Proceduresmethods
Classification: LCC RD546 | NLM WI 770 | DDC 617.5/57dc23LC record available at https://lccn.loc.gov/2019015650
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Dedication
To my wife, Cheryl, and my family for your many years of support; and to the surgical trainees who drive each of us to be at our best each and every day.
K.L.
To my family, my colleagues, and mentors, but most of all to my trainees and patients, who motivate us to always to strive for excellence.
W.J.
Preface
Forty years ago, many of the operations described in this volume were performed rarely, if at all, and almost never outside of a few highly specialized referral centers. Over that relatively short span of time, hepatobiliary/pancreatic (HPB) surgery has progressed from a high-risk proposition, practiced by a small band of pioneering surgeons, to relatively common practice, with the expectation of good outcomes for the vast majority of patients. Indeed, HPB surgical procedures are now widely performed, from academic tertiary referral centers to community hospitals, and the indications for many procedures continue to expand.
Many factors have played a role in the transformation of this field, not the least of which has been improvements in operative and perioperative care generally. Another major factor has been the evolution of HPB surgery into a recognized area of specialization. The early practitioners, many of them legendary figures in surgery, laid a solid foundation and passed on the knowledge of many hard lessons learned over the years. The next generation expanded this knowledge base and refined the surgical techniques and management approaches that propelled HPB surgery into the mainstream. With the framework established, it then became possible to shift the focus to improving outcomes in patients with HPB-related diseases, rather than merely surviving the perioperative period. It is our charge now to continue to advance the field, not only by further improving the safety of the operations, but to better align the indications with an increasing understanding of the disease processes in order to improve patient selection.
We are the beneficiaries of these several decades of hard work on the part of many surgeons, to whom we owe a large debt of gratitude. Although their efforts set the stage to allow the routine performance of major HPB surgical procedures, the margin of error remains very narrow. These operations can be very challenging from a technical standpoint, and even minor miscalculations can have profound adverse consequences.
This atlas is meant to provide detailed description of the technical aspects of liver, biliary, and pancreatic operations, many commonly performed but others less so. We are indebted to our coauthors, all experts in the field, who have shared their insights into these procedures based on their extensive experience. Although the focus is on the technical conduct of operative procedures, efforts are made to include discussion of indications/contraindications, preoperative assessment, and perioperative management. Our aim was to provide a volume valued equally by trainees and established HPB surgeons.