The first complete general study of acute necrotizing hemorrhagic pan creatitis was made in 1889 by Reginald Fitz. If we survey the therapeutic evolution of this severe illness, we may briefly summarize it into three pe riods: (a) resolutely surgical treatment, from approximately 1880 to 1938; (b) much more conservative treatment, from 1938 to 1963; and (c) a return to surgery, from 1963 onward. Hoffmann, in 1911, was probably the first to advocate the removal of the necrotic portion of the pancreas. In 1933, Okinczyc wrote: "The ope rative indications are not a matter for discussion; emergency surgery must be quick to manage the patient's poor resistance." So: "go right to the target, expose, drain ... and hope " Leriche and Arnaud, more inge nious, said: "The aim of the operation is to avoid diffusion of the pan creatic juice into the abdominal cavity and limit the harmful effects of what remains in situ ... " With the progress in intensive care techniques, the "conservatives" emphasizing the poor results of surgery had no difficulty in imposing their point of view. Subsequently, in 1963, a new period began with the first successful emergency pancreatoduodenectomy, performed by Watts. If nowadays surgery for the secondary stage of necrosis or abscesses is generally accepted, emergency surgery still remains questionable even if not systematically refused. Many surgeons perform it under three condi tions: the worsening of the patient's general state despite medical treat ment, a dubious diagnosis, and a biliary etiology."

The increasing incidence of both chronic pancreatitis and pan creatic cancer was the primary impetus for the organization of this meeting, an additional factor being the widespread existence of pancreatic disease within Italy itself. It is well known that the treatment of chronic and particularly of acute pancreatitis is still a matter of controversy, and it seemed useful to compare our own experience with that of other centers working in the same field. Consequently, in addition to numerous Italian specialists in the field, doctors from the Federal Republic of Germany, Denmark, Great Britain, France, and Austria were invited to attend the meeting. The symposium lasted two days and comprised eight sessions dealing with the anatomy and physiology of the pancreas and the pathophysiology, diagnosis, and treatment of pancreatic diseases. A central feature of the discussion on the surgical treatment of chronic pancreatitis was the debate between those who favor the use of drainage and those who believe resection to be the best treatment. Finally, I would like to thank Dr. Cavallini and Dr. Pederzoli very much for their help in organizing the meeting and also the local authorities for their aid. Professor Adamo Dagradi Director of the Institute of Clinica Chirurgica, Verona Opening Address I am pleased to welcome all partlclpants and particularly the guests from abroad, to this meeting on the clinical evaluation of pancreatitis."

The preceding monograph: ''Vagotomy - latest advances", Springer-Verlag, 1974 ed. by F. Holle and S. Andersson reported an innovation in surgery: the so-called "selective proximal vago tomy (spv) with pyloroplasty (pypl)". The usefulness of the method was put to the test in cases of peptic ulcer disease and in dog experiments. No claim was made - as some reviewers erroneously supposed - that the method was a comprehensive presentation of the surgery of peptic ulcer disease or even that it offered a patent solution to this subject Instead, it should be regarded as the initial step towards this goal. The clinical results obtained during the years 1964-74 encouraged us to pursue this line of approach with a view of reaching a stomachpreserving or non-resective method in peptic ulcer surgery and to test the appli cability of the method to other benign disorders of the stomach. After 16 years of testing and experience with over 2000 cases S (Dec. 1t. 1979) of selective proximal vagotomy with pyloroplasty, supplemented by advanced studies on the pathophysiology of the method, an additional volume is now proposed: "Vagotomy and Pyloroplasty, advances 1975-1980", Springer-Verlag 1980. This subsequent volume deals primarily with improvements and findings made during the last 5 years. It also refers to important questions concerning the practical performance of the method which arose from congresses and discussions in this field. These are: 1. Definition, efficiency and effects of the model: spv + pypl. 2.

The acute abdomen often perplexes the expert as well as the young physician. There are few areas in medicine in which Hippocrates' aphorism-the art is long, life is short, decision difficult, and delay perilous-is more applicable than here. Too often the harried physician fails to listen to the patient who is trying desperately to suggest the diagnosis. The significance of various types and location of pain often are neglected by the doctor. Physical findings are influenced by experience; the presence or absence of tenderness or a mass may be answered in entirely different ways by various observers. Because solid facts frequently are lacking, attempts to resolve diagnostic dilemmas by computer analysis or by algorithms are not likely to be successful. Fortunately, in the great majority of cases, unusual and difficult diagnostic procedures are not necessary for the identification of the acute abdomen and of the major disease. Astute clinical judgment must be based primarily upon careful attention to the pa tient's words and detailed observation."

The development of accurate hormonal assays in recent years has evoked much interest in the area of anaesthesia and surgery. In an effort to allow an exchange of ideas and new information in this area, the First International Symposium on Endocrinology in Anaesthesia and Surgery was held in Bonn during September 1978. The contents of this book represent much of the information presented by the leading authorities in this field. The presentations were grouped in three areas: 1. Basic problems of endocrinology in anaesthesia and surgery; 2. The response of the endocrine system to anaesthesia and surgery; 3. Hormone and anaesthetic management of endocrine disease. As with any multi-authored text, there is both repetition and diversity but hopefully the reader will be able to obtain much of the useful information. As Editors, we wish to express our deep appreciation to Profes sor R. Frey and Springer-Verlag for including this book in the series on "Anaesthesiology and Intensive Care Medicine." H. Stoeckel T. Oyama Table of Contents I. Basic Problems of Endocrinology in Anaesthesia and Surgery H. Breuer Basic Principles Regulating the Endocrine System . . . . . . . .. 3 G. Wesemann and E. Grote Pathophysiology of Intra- and Postoperative Stress .. . . . . .. 10 M. Trede Surgical Treatment of Endocrine Disorders .. . . . . . . . . . .. 24 T. Oyama Influence of Anaesthesia on the Endocrine System ... . . . .. 39 L. Nocke-Finck Radioimmunological Determination of Hormones."

Notfalle erfordern adaquates chirurgisches Vorgehen, da ansonsten lebensbedrohliche Komplikationen im postoperativen Verlauf auftreten koennen. Jeder Arzt muss deshalb die Massnahmen der Notfallmedizin und der chirurgischen Erstversorgung beherrschen. Die "Definitive chirurgische Erstversorgung" - ein etablierter Klassiker in neuer Auflage - von G.H. Willital und A. Holzgreve soll jedem chirurgisch tatigen Arzt eine wertvolle Orientierungshilfe sein. Alle Erkrankungen und Unfalle, die eine chirurgische Erstversorgung notwendig machen, werden aufgefuhrt. Die chirurgische Erstversorgung aller Falle wird einheitlich systematisch gegliedert und klar und pragnant dargestellt. das erfolgreiche Werk (65.000 Exemplare und 5 Auflagen bei Urban & Schwarzenberg) erscheint jetzt in der 6. Auflage bei Walter de Gruyter alle Erkrankungen und Unfalle, die eine chirurgische Erstversorgung notwendig machen, sind sorgfaltig aktualisiert einheitlich systematisch gegliedert in Leitsymptome, Diagnostik und Therapie Kitteltasche-Format fur schnelles Nachschlagen

Written by residents for residents, the updated 6th edition of this best-selling handbook provides you with exactly the information you need to overcome the vast majority of challenges you encounter during your surgical residency. With its pocket-size and easy-reference format, this resource enables you to quickly access the right guidance...at the right time...about what to do and how to do it. No resident should be without this essential surgical guide! Provides comprehensive guidelines for the treatment of the most common surgical conditions, including preoperative and postoperative care, as well as relevant pathophysiology. Includes surgical management that encompasses state-of-the-art technology and emphasizes minimally invasive techniques, including important coverage of laparoscopic cholecystectomy, appendectomy, and herniorrhaphy. Provides guidelines for proper medical record keeping as well as other mediocolegal aspects of surgical care. Offers detailed figures depicting important anatomical structures and operative techniques. New chapters cover Surgical Risk Assessment, Head and Neck Malignancy, Mediastinal Tumors, Dialysis Access, and Robotics. Rapid References section offers handy formulas and charts in one easy-access location. Thoroughly revised content throughout ensures that you stay up to date. Expert ConsultT eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, Q&As, and references from the book on a variety of devices.

Surgery Morning Report: Beyond the Pearls is a case-based reference that covers the key material included on the USMLE Step 2 and Step 3, as well as the surgery clerkship. Focusing on the practical information you need to know, it teaches how to analyze a clinical vignette in the style of a morning report conference, sharpening your clinical decision-making skills and helping you formulate an evidence-based approach to realistic patient scenarios. Each case has been carefully chosen and covers scenarios and questions frequently encountered on the Surgery boards, shelf exams, and clinical practice, integrating both basic science and clinical pearls. "Beyond the Pearls" tips and secrets (all evidence-based with references) provide deep coverage of core material. "Morning Report"/"Grand Rounds" format begins with the chief complaints to the labs, relevant images, and includes a "pearl" at the end of the case. Questions are placed throughout the case to mimic practical decision making both in the hospital and on the board exam. Written and edited by experienced teachers and clinicians; each case has been reviewed by board certified attending/practicing physicians. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

The Operation Primer provides excellent photographic step-by-step guidance to the surgical procedure. It has been produced to describe the operation in the simplest manner possible without over-simplifying. At the core of the Operation Primer is the section on Nodal Points, where the key surgical steps are described in detail. This surgical guide book provides essential reference material for surgeons wishing to update their knowledge in this specific area.

The Operation Primer Laparoscopic Hysterectomy is specially intended for those gynecologists who wish to familiarize themselves with minimally invasive hysterectomy techniques. This Operation Primer is an excellent teaching tool, accurately describing a standardized technique not only for novices but also for experienced laparoscopic surgeons. It provides a detailed overview of presurgical considerations and preparation, key surgical steps and highlights possible pitfalls of laparoscopic hysterectomy.

This Operation Primer on total laparoscopic hysterectomy (TLH) and laparoscopic supracervical hysterectomy (LASH or LSH) follows the step-by-step concept and provides a detailed manual for gynecologists who want to apply laparoscopic techniques for hysterectomy.

"

Fully revised and updated in light of the changes to the format of the MRCS examination, this second edition of Get Through MRCS: Anatomy provides candidates with the knowledge and practice necessary for excelling at the challenging MRCS part B OSCE examination. The updated new edition of the highly-praised Get Through MRCS: Anatomy Vivas Fully revised in accordance with the changes to be focussed on the OSCE format Detailed model answers and full explanations to ensure thorough understanding of how to get the best results Plentiful illustrations and high-quality photographs in full colour throughout Written by the experienced author of the highly successful first edition, Simon Overstall has extensive knowledge of the exam, both in teaching offline courses and authoring MRCS revision texts. Get Through MRCS: Anatomy is essential reading for MRCS candidates wanting to achieve expert anatomical knowledge and to ultimately earn high results within their postgraduate examinations.

This book covers the following on a wide variety of surgery cases such as general surgery, neurosurgery, orthopedic and traumatology, otorhinolaryngology-head, and oncology. Other topics related to surgery in this volume include anesthesiology, oncology, and anatomical pathology. This book provides an authentic, fresh, and educational case in each section. The purpose of this book is to contribute some perspective on basic science and clinical evidence of unusual case, which will give educational benefit to our readers. In addition, this volume is designed to meet the demand of practitioners to face challenging and unexpected cases in the surgical field, which readers will find very helpful. This valuable book contains 38 real cases in surgery. Access to case scenario is given at the beginning, followed by physical examination, differential diagnosis, and management in surgery. We emphasize in evidence-based medicine to expand the knowledge of surgical education and practice. The explanation was conducted understandably, and key learning points were summed up to help the readers. We believe that our readers will find this text, written by our best practitioners and specialists, very informative and useful.

The Viva Voce is a particularly difficult element of the MRCS exam since candidates will be tested across a broad range of topics in surgery, pathology, critical care and basic science, and also as candidates are unsure what to expect, or how to prepare for such an exam. Questions for the MRCS Viva is an essential guide to sitting and passing the Viva Voce part of the MRCS exam. Each subject area offers 20-30 questions, which follow a conversational pattern where new questions follow logically from previous answers - exactly as one would expect in the exam itself. Written by recently qualified surgeons who are now actively involved in the teaching and support of new trainees, this book is the closest a candidate will get to being a fly on the wall in a Viva Voce examination.

Liver steatosis or nonalcoholic fatty liver disease (NAFLD) is a progressive disorder characterized by the fat accumulation in the parenchyma of the liver. The progressive form of NAFLD called nonalcoholic steatohepatitis (NASH) is the advanced condition that shows different grades of fibrosis, which could progress to cirrhosis, hepatocellular carcinoma and liver-related morbidity and mortality. Bariatric surgery gains attention as a potential treatment for liver steatosis because different studies revealed an improvement in 90% of cases of fatty liver after surgery. The improvement occurred within the first year and persisted up to five years. Pathogenic mechanisms that are involved in the evolution steatosis are intimately connected with insulin resistance, type 2 diabetes (T2D) and the metabolic syndrome. Bariatric surgery is a powerful treatment to ameliorate all these conditions. The aim of this book is to update the actual evidence about liver steatosis, non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in morbidly obese patients, the diagnostic methods and the evolution after the different techniques of bariatric surgery.

Surgical site infection (SSI) is one of the most frequent complications after abdominal surgery as abdominal procedures are often clean-contaminated, contaminated or even dirty procedures, so long the gastrointestinal tract, plenty of microorganisms, is entered. SSI is associated with morbidity and mortality, and reduces the patients' quality of life after surgery. Moreover, it prolongs hospital stay and requires increased instrumentation, medication and complementary tests, altogether representing an economic burden for the Health Services. This has led to the development of several Guidelines and Consensus documents, including prophylactic measures to prevent SSI. Different scientific societies, including the World Health Organization (WHO), the Center for Disease Control (CDC), the American College of Surgeons (ACS) and the Surgical Infection Society (SIS), have published recommendations for the prevention of SSI in the last years. All the documents agree with most of the recommendations. However, the evidence grade of these recommendations is often low to moderate and with the aim to generalise these measures to all the surgical procedures, the extrapolations lead to a lowered evidence power. Thus, in some cases the force of the recommendations is based on the opinion of experts in the field. The aim of this book is to revise the actual evidence about these prophylactic measures in abdominal surgery.

This comprehensive manual discusses the many aspects of inflammatory bowel disease (IBD), providing relevant information along with practical guidance. The reader is also directed to additional resources for extra and current information. This book comes at a time when the number of people suffering from the two major forms of IBD, ulcerative colitis (UC) and Crohn's disease (CD), is rising around the globe. Despite their huge impact on daily life and health economics, these diseases are not fully understood, and diagnosis and treatment remains a significant challenge. IBD nurses are increasingly recognised as key clinicians within the multidisciplinary team caring for people with IBD. Through experience and specialist knowledge IBD nurses provide timely support, advice, and treatment for people living with this unpredictable condition. IBD nurses are also well placed to liaise with the wider team, developing patient centred services which best fit their local health framework. The combined international expertise and accessible guidance here will equip nurses, or any clinician wanting to increase their competence in IBD management. Thereby this manual aims to contribute to the optimisation of IBD care throughout the world.

This book represents an effort to document the experience of a carefully-chosen group of international surgeons, regarding the use of imaging technology in their everyday practice. The aim of this book is to help medical students and surgeons at all levels of training and practice to understand the basics of the more common imaging techniques (CT, MRI, MRCP, US, XR, radionuclide scan, etc.), including their advantages and disadvantages and their optimal use and limitations. Following that, the application of these imaging modalities, including the most current developments, in the different fields and subspecialties of surgical practice (including, but not limited to, surgical oncology, neurosurgery, endocrine surgery breast surgery, hepatobiliary surgery, pancreatic surgery, transplantation, urology etc.) is presented in detail. What is important about this book is that it is written by an international group of surgeons who are experts in their respective fields and who offer us here their wisdom and experience, regarding what the communication between the surgeon and the radiologist should be, in order to provide these complex patients with the best possible care. Apart from the radiological and imaging tools commonly used in current practices, future prospects and challenges regarding how imaging technology can increase surgical efficiency in the future are explored. The overall goal of this book is to help surgeons in today's technology-driven environment have a proper understanding of the use and limitations of modern imaging techniques.

Many surgical procedures are performed by ambulatory surgery and account for around 60-70% of all surgical procedures. This book presents new research in ambulatory surgery, and discusses advances in other surgical procedures. The topics discussed include ambulatory surgery as well as breast reconstruction, thyroid goitre surgery, and midface lift surgery.

Bariatric surgery has become a mainstay in the treatment armamentarium of morbid obesity. Randomised trials have established the efficacy of bariatric surgery towards sustained weight loss, along with significant improvements in related comorbidities, quality of life measures, and all-cause mortality. This compilation discusses the indications and complications of bariatric surgery as well as several other topics that include omentectomy, post-surgery atrial fibrillation, blood transfusions, and others.

Packed with detailed, full-color illustrations and live surgery images, market-leading SURGICAL TECHNOLOGY FOR THE SURGICAL TECHNOLOGIST: A POSITIVE CARE APPROACH, 5e, delivers the most up-to-date and comprehensive coverage of over 200 essential surgical procedures. It also includes essential topics such as equipment and supplies, operative preparation, practical and technical considerations, and postoperative considerations. "Pearls of Wisdom" features offer practical insight from surgical technologists in the field, and numerous learning resources help you maximize your course success -- including "A POSITIVE CARE" memory tool, real-life case studies with critical thinking questions, and the powerful digital learning solution MindTap. Preparing you for real-world practice, SURGICAL TECHNOLOGY FOR THE SURGICAL TECHNOLOGIST, 5e, is the ultimate resource for helping you anticipate the patient's and surgeon's needs before, during, and after a surgical procedure.

This book highlights remarkable new endoscopic, laparoscopic, and thoracoscopic approaches to the removal of surgical lesions for different pathologic conditions under general endotracheal anesthesia in infants and children. It details how newer techniques in airway management, monitoring, regional nerve blocks for these innovative minimally invasive approaches have resulted in a decrease in intraoperative and postoperative morbidity and early recovery process after pediatric anesthesia. This unique book contains features that provide the audience with several clinical scenarios where exceptional surgical outcomes are achieved with optimum pre-op preparation via collaborative team efforts. To date there is no other textbook emphasizing the anesthetic and surgical management during the most innovative advances in endoscopic surgery in children. Per oral endoscopic myotomy (POEM) for the definitive treatment of achalasia in children is probably the most advanced endoscopic surgery done successfully in children. POEM is the best example of endoscopic surgery performed via natural orifices known as the Natural orifice transluminal endoscopic surgery (NOTES). Another new laparoscopic surgical intervention -Median Arcuate Ligament surgical release for Median Arcuate Ligament Syndrome (MALS) for patients with Postural Orthostatic Tachycardia Syndrome (POTS) is described with established perioperative protocols emphasizing the need for early admission, intravenous hydration, and premedication. Novel approaches in the anesthetic management in children with short bowel syndrome for bowel lengthening techniques like the serial transverse enteroplasty (STEP) and in teenagers for laparoscopic bariatric surgery with adjustable gastric banding (AGB) and vertical sleeve gastrectomy (VSG) for morbid obesity are new areas that would enlighten the readers. Anesthetic Management in Pediatric General Surgery is an invaluable resource for pediatric anesthesiologists, surgeons, and their trainees specializing in the care of pediatric patients.

This book provides a comprehensive state-of-the art overview on the main trends in the newest endoscopic, robotic, and minimal invasive surgical innovations. It also aims to give insight on some of the innovative ideas around Gastro-intestinal Surgery and Endoscopy to stimulate further activities. It contains established knowledge in the field of endoscopic and surgical techniques, and the integration of these new findings in updated therapeutic decision making are demonstrated. The text reviews the latest literature on the subjects and describes the decision making to establish new therapeutic options in the management of diseases applying new technologies. These new techniques are described in detail, which provide excellent back-up information for clinicians in daily practice. Written by experts in the field, Innovative Endoscopic and Surgical Technology in the GI Tract is a valuable resource of knowledge for clinicians, surgeons, nurses, technicians, students and researchers with an interest in GI- disease.

This book is a detailed resource on the technical aspects of pediatric neurosurgery that relate to vascular malformations of the brain and spinal cord. It introduces concepts relevant to cerebrovascular system development and the classification of vascular malformations. Information on a range of disorders is then provided with an emphasis placed on answering frequently asked questions in relation to a particular condition. Therefore, enabling the reader to systematically improve their understanding of how approach treating patients utilizing techniques such as ultrasound and spinal angiography. The chapters, authored by experts in their respective field, provide a standard of care based on current diagnostic and management guidelines for pediatric neurosurgical diseases. Pediatric Vascular Neurosurgery: Technical Nuances in Contemporary Pediatric Neurosurgery (Part 2) is a comprehensive overview of how to approach diagnosing and treating a range of vascular malformations encountered in pediatric patients. The problem-solving approach of this work makes it a valuable addition to the literature and suitable for use by residents, fellows and consultants within pediatrics and allied specialities, including Neurosurgery, Neurology, Neuro-anesthesia, Neuro-critical care and advanced health care providers amongst others.

This book discusses all thoracic diseases of surgical interest, from thorax malformations to airways disorders. It is divided into six main sections; the first two analyze general aspects, while the following three focus on malformations of the thorax, airways, esophagus and diaphragm. The final section describes the main pediatric tumors involving the chest and internal thoracic organs. Each chapter starts with a classification of the main pathologies related to the anatomical region considered. For each pathology, the various aspects of the diagnostic-therapeutic procedure are described in details - from the clinical presentation and diagnosis to the pre-operative preparation, the surgical aspects, and the post-operative course. Possible future developments are also evaluated. The volume will be a useful tool for specialists in pediatric and thoracic surgery, but will also represent an educational resource for medical and nursing students.