Surgery of the Liver, Bile Ducts and Pancreas in Children, Third Edition describes the modern approach to the diagnosis, management and surgery of childhood conditions of the liver and associated structures. The first edition was recognized worldwide as a landmark publication and helped to establish pediatric hepatobiliary surgery as a discrete subspecialty; the second was expanded to include pancreatic diseases, transplantation and trauma. This third edition is overseen by a new editorial team from two world-leading centers for children's liver surgery: King's College Hospital in London, and Lurie Children's Hospital in Chicago. The book has been further expanded and updated by a team of international experts to take account of the very latest advances in research and practice.

Molecular diagnosis and gene therapy are of increasing interest and importance in clinical medicine. The increasing understanding of the pathogenesis of human diseases at the molecular level opens new perspectives for their diagnosis, prevention and therapy. The first part of this book, the proceedings of Falk Symposium No. 88 'Molecular Diagnosis and Gene Therapy', held in Basel, Switzerland, October 22-23, 1995, is aimed at an in-depth understanding of the methodology of molecular diagnosis by hybridization analysis, polymerase chain reaction and others. Further, the applications and limitations of these technologies in clinical medicine for the detection of genetic, malignant and infectious diseases are reviewed. In the second part of the book, the basic strategies of gene therapy are presented, including gene transfer and targeting. Further, experimental and clinical applications of gene therapy strategies for the prevention and treatment of hepatic and other diseases are presented. Molecular diagnosis and gene therapy are clearly going to be key elements of clinical medicine after the year 2000. In this sense, the book should allow basic scientists as well as clinicians to be informed about the state-of-the-art of molecular diagnosis and gene therapy and should provide a perspective for future developments in molecular medicine.

This book provides a quick, pattern-based reference for interpreting histologic changes in non-neoplastic liver. It is designed to guide the reader based on morphologic pattern and basic clinical information. Each chapter covers a broad but identifiable pat tern of pathologic liver findings (e.g., "portal inflammation" or "steatosis") and discusses the major disease entities that manifest as such a pattern. As liver biopsies can be complex and daunting, such an approach should improve the reader's ability to identi fy a likely diagnosis or differential and to distinguish among the possible disease enti ties. Sample reports at the end of each chap ter offer guidance on how to sign out cases. Non-Neoplastic Liver Pathology: A Patholo gist's Survival Guide will be of value to practicing pathologists without specialized training in hepatic pathology, pathology residents and fellows trying to learn the basics of non-neoplastic liver pathology, and hepatologists interested in reviewing liver biopsies with pathologists

Dietary Interventions in Liver Disease: Foods, Nutrients, and Dietary Supplements provides valuable insights into the agents that affect metabolism and other health-related conditions in the liver. It provides nutritional treatment options for those suffering from liver disease. Information is presented on a variety of foods, including herbs, fruits, soy and olive oil, thus illustrating that variations in intake can change antioxidant and disease preventing non-nutrients that affect liver health and/or disease promotion. This book is a valuable resource for biomedical researchers who focus on identifying the causes of liver diseases and food scientists targeting health-related product development.

Alcoholic liver disease has once again entered our collective conscience. A paper in 2012 showed the utility of orthotopic liver transplantation (OLT) in acute alcoholic hepatitis. As expected, this opened the floodgates. Every liver transplant program in the USA is now under pressure to list and transplant patients with alcoholic liver disease (ALD), resulting n a shift in the type of patients to admit and list for OLT. In consultation with Dr. Norman Gitlin, Dr. Norman Sussman and Dr. Michael Lucey have put together a collection of articles on current practices and future trends in the management of alcohol-related diseases. Expert authors from top institutions have contributed articles on the following topcs: Histopathology; Alcohol and the Law; Alcoholic Liver Disease in Children; Alcohol Use Disorder; Pathogenesis of ALD; Acute Alcoholic Hepatitis; Nutrition and Malnutrition in ALD; Alcoholic Cirrhosis; Liver Transplantation for Alcoholic Liver Disease; CNS effects of Alcohol; and Will Studies in NASH Help to Manage AS. Readers will come away with current clinical information to help them to make clinical decisions that will improve patient outcomes.

Since the publication of the first edition, there have been advances in both the diagnosis and the management of many of the cholestatic liver diseases. Cholestatic Liver Disease, Second Edition thoroughly updates the topics previously addressed, such as primary biliary cirrhosis, primary sclerosing cholangitis and cholestatic variants of drug hepatotoxicity and viral disease. New treatments, such as the development of the farnesoid X receptor agonists for the treatment of PBC, are highlighted. Current guidelines and areas of uncertainty are also covered. Additionally, new chapters have been added to reflect the changing landscape of cholestatic liver disease. Cholestatic Liver Disease, Second Edition is a concise yet comprehensive summary of the current status of the field and is of value to clinicians and researchers interested in patients with cholestatic liver disease provide that will help to guide patient management and stimulate investigative efforts.

Intraductal papillary mucinous neoplasms (IPMNs) represent an opportunity to treat pancreatic tumors before they develop into aggressive, hard-to-treat cancers. Beginning with morphological classification and its clinical significance, natural history, and malignant change of both main duct and branch duct IPMNs, this book covers the whole field of IPMNs of the pancreas. It reviews the various methods of investigation: imaging, diagnostic investigation of cyst fluid, and those using pancreatic juice; and also examines aspects ranging from the development of malignancy to the timing and method of resection, focusing on both main duct and branch duct IPMNs. Aimed at residents, clinical fellows, and pancreatologists who treat patients with this common disease of the pancreas, this book is a landmark in the current understanding and future perspectives of IPMNs of the pancreas.

Hepatitis C Virus and Liver Transplantation is designed to provide a comprehensive and state-of-the-art overview of the major issues specific to the field of liver transplantation and hepatitis C virus infection. The sections of the book have been structured to review the overall scope of issues of recurrent hepatitis C in different complex settings, including retransplantation, HIV-coinfected patients or in the setting of suboptimal graft donors. This book provides up-to-date information on the application of new therapies to the field of liver transplantation. It provides the most recent data on their efficacy, the management of side effects, as well as the potential interactions and specific problems associated with their use in the transplant setting. Finally, an appraisal of the risks and benefits of using organs from anti-HCV positive donors is presented. This book provides concise and actual materials for several important topics that are simply not adequately covered by current available literature. Hepatitis C Virus and Liver Transplantation will provide a unique and valuable resource in the field of liver transplantation and will be of great value to Hepatologists, Transplant and Abdominal Surgeons, Oncologists, as well as Fellows and Residents training in these fields.

Autoimmune (IgG4-related) Pancreatitis and Cholangitis reviews the breadth of clinical, imaging, histological, laboratory, and imaging features associated with IgG4-associated systemic disease, especially AIP and IAC. Written by experts in their fields, each chapter includes an overview of existing data as well as the most up-to-date scientific information and emerging data. The book also addresses areas of uncertainty and controversy, briefly highlighting clinical and research needs relative to the respective topic. Comprehensive and easy to use, Autoimmune (IgG4-related) Pancreatitis and Cholangitis is a valuable resource for physicians who deal with or are interested in these complex disease processes, including gastroenterologists, hepatologists, and surgeons.

Liver Immunology: Principles and Practice, Second Edition begins with important information about the epidemiology and mortality of liver disease worldwide. This information is followed by chapters related to basic immunology, application of liver immunology for diagnosis, and several excellent chapters that provide a solid foundation for understanding immune-mediated liver disease, including those associated with the biliary tree. A chapter on non-hepatic manifestations of immune mediated liver disease helps provide context for how these diseases affect the patient overall.  In addition, chapters discuss various discrete immunologically-mediated infectious liver disorders including those related to bacteria, parasites, and all of the classic viruses. Chapters on the traditional autoimmune liver diseases --  primary biliary cirrhosis, autoimmune hepatitis, primary sclerosing cholangitis as well as overlap syndrome – are also included. The breadth of this comprehensive second edition is highlighted by chapters on alcoholic liver disease, non-alcoholic fatty liver disease, and drug-induced liver disease, among others.  This invaluable new edition ends with a forward-looking view of future directions and how the field might meet the challenge of refractory patients.  Developed by a renowned group of authors, Liver Immunology: Principles and Practice, Second Edition will again serve as a comprehensive textbook by providing an excellent overview for this rapidly evolving field. It greatly adds to the understanding of the pathogenesis of these diseases, while also providing novel insights that can be harnessed into helping improve the care of patients afflicted with various immune-mediated diseases.  This volume will again be a must-read for clinicians at all levels, investigators and students.

A comprehensive guide on hepatology featuring 477 top-quality colored figures. With colored textual emphasis, flowcharts and tables for the best didactics and systematics and about 7000 up-to-date references, this book provides a short historical review on hepatology.

Autoimmune Liver Diseases summarizes the recent high-impact research and clinical findings obtained in Japan in the study and treatment of autoimmune liver diseases. Although these disorders are relatively rare, they are recognized as an important group of refractory liver diseases, the most common of which are autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC). The book therefore comprises two major sections, one dealing with AIH, the other with PBC. AIH in Japanese patients creates a unique disease population, as its clinical features are different from those of Western patients resulting from the different genetic background of the two patient populations. Also, mouse models of neonatal thymectomy-PD-1 knockout mice, clinical analyses of acute hepatitis-like manifestations, and research findings on IgG4-related autoimmune hepatitis have been reported in Japan and are included in this book. A disease-susceptibility gene specific to Japanese PBC patients has also recently been discovered. Because of the relatively homogeneous population of Japan, analyses conducted with Japanese PBC patients have yielded findings that are highly relevant to the pathogenesis of the disease. Furthermore, new pathological staging criteria, anti-gp210 antibodies and the basis they provide for improved accuracy of prognosis, treatment with bezafibrate, and the outcomes of living-donor liver transplantation are also presented here. This volume therefore serves as a useful resource not only for hepatologists, but also for researchers, clinical residents, and medical students both in Japan and in other countries.

The Clinical Pocket Guide to Advanced Practice Palliative Nursing is a companion guide to Advanced Practice Palliative Nursing, the first text devoted to advanced practice nursing care of the seriously ill and dying. Each chapter of this pocket guide presents point-of-care guidance on palliative care issues for quick reference in daily practice. Edited by leaders in the field, this handbook provides consistency in the nursing process from assessment to management and evaluation of symptoms and various clinical situations. The Clinical Pocket Guide to Advanced Practice Palliative Nursing contains clinical pearls developed from the textbook and practical tools on pain and symptom assessment, functional status, and communication, making it an ideal resource for practicing APNs.

This handbook provides a comprehensive overview of common disorders affecting the pancreas and the bile duct. The book reviews the anatomy and laboratory test relevant to the pathophysiology of the disease, categorizes the symptoms under clinical scenarios like "incidental finding" or "painless jaundice", defines accuracy (or lack of) of the investigations used, and formulates a management plan as per evidence-based recommendations. The spectrum of diseases covered include commonly occurring benign conditions like pancreatitis, gall stone disease, bile duct strictures, and malignant diseases of the pancreas, gall bladder and the bile ducts. Also included are topics on motility disorders of the pancreaticobiliary system and pre-malignant conditions. Written by experts in the field, Pancreas and Biliary Diseases: A Point of Care Clinical Guide is a valuable reference resource for clinicians who need the latest evidence-based approach to manage these complex patients and answer questions the patient or the referring doctors may have regarding pancreas and biliary diseases.

This volume presents the most recent developments in diagnosis and treatment of patients with gastroesophageal reflux disease (GERD) and those who continue to be refractory to conventional GERD therapies. The book delineates the role of newly developed endoscopic therapies in GERD and outlines the best candidates for surgical fundoplication. Topics as the risks associated with GERD, lifestyle modification in GERD and the role of H2RA and proton pump inhibitor therapy in treating reflux disease are also explored. Written by authorities in the field, Diagnosis and Treatment of Gastroesophageal Reflux Disease is a concise yet comprehensive resource that is useful for primary care providers, gastroenterologists, pulmonologists, surgeons and ENT specialists.

This text provides a comprehensive review of ERCP and EUS and the clinical conditions for which they are employed. Presented in a case-based format with accompanying videos, it will serve as a valuable practical clinical resource for gastroenterologists with an interest in ERCP and EUS. The text highlights major techniques involved in ERCP, reviews complications and recent data on preventing post-ERCP pancreatitis, and discusses important issues in training in ERCP including use of endoscopic simulators and assessment of competency as emphasized in the new ACGME guidelines. For biliary diseases, new techniques for managing biliary stones, novel technologies for diagnosing indeterminate biliary strictures, and new devices for treating benign and malignant strictures are also highlighted. For pancreatic diseases, advances in minimally invasive endoscopic techniques for pancreatic stones and strictures, and management of the complications of pancreatitis are reviewed. Furthermore, ERCP is not limited by age, pregnancy or history of abdominal surgeries and special considerations particular to these patient populations are also discussed. The EUS chapters review the breadth of equipment available for performing EUS and EUS-FNA, detail the technique of performing EUS-FNA, and explore pertinent issues with training and assessing competency analogous to ERCP training. Valuable insights on the basics of cytopathology relevant to the endosonographer are summarized. The classic indication for EUS of staging luminal cancers is examined in detail while pancreaticobiliary indications are discussed highlighting newer adjunctive technologies including elastography and contrast-enhanced EUS. Although in its infancy, the brave new world of therapeutic EUS is explored with a focus on endoscopic necrosectomy, EUS-guided biliary and pancreatic access as well as the exciting possibilities of EUS-guided radiofrequency ablation and injection of anti-tumor agents. ERCP and EUS: A Case Based Approach will serve as a very useful resource for physicians who perform or refer patients for ERCP and EUS. It provides a concise yet comprehensive summary of the current status of ERCP and EUS that will help guide patient management and stimulate clinical research.

This book is a concise and up-to-date review of the clinical features, pathophysiology, diagnosis, and treatment of patients with hepatitis C. Busy health care professionals who want a quick review of hepatitis C and new developments in treatment for hepatitis C will benefit from this succinct guide. Hepatitis C virus primarily infects liver cells and can lead to chronic damage to the liver. Patients with hepatitis C infection often develop liver sequelae such as fibrosis, cirrhosis, and hepatocellular carcinoma if left untreated. It is estimated that 150 million people worldwide are infected with hepatitis C virus, and if eradication is to be achieved it is imperative to diagnose and treat such individuals.

This volume presents a concise yet comprehensive overview on all facets concerning the complications of cirrhosis. Structured in three sections, the book reviews the natural history of cirrhosis, the diagnostic and predictive tools available to assess the disease, complications, and treatment options such as liver assist devices and transplantation. Topical concerns in the management of patients with cirrhosis are also addressed, including issues pertaining to the delivery of quality care in this patient population. Written by experts in their fields, Complications of Cirrhosis: Evaluation and Management serves as a valuable resource for practitioners and physicians-in-training on the subject of cirrhosis.

The aim of this book is to present a unique compilation of lectures given by international speakers at the Hammersmith Hospital during the recent Meetings in Hepato-Pancreato-Biliary and Transplantation. New therapeutical approaches, advances in oncology and in diagnostic imaging, which reduce the need for invasive techniques and reach an improvement in survival and quality of life in cancer, are considered in this book. Modern literature has been reviewed with special reference to articles of general interest. In the clinical management of patients with liver, bile duct and pancreas diseases, it is important to assess the degree of disturbance and to diagnose the causative insult, and therefore clinical and laboratory methods of assessing each of these pathologies are of high interest. This version is an up-to-date account of diseases of the liver, biliary tract and pancreas, including transplantation, which we trust will be of value for surgeons, physicians and pathologists and also a reference book for medical students.

Hepatic Encephalopathy and Nitrogen Metabolism is an interdisciplinary symposium bringing together basic science and clinical applications. It contains up-to-date research findings at the highest scientific level.

Hepatocellular carcinoma is one of the most common fatal malignan cies of mankind. Up to a few decades ago it was looked upon as a cancer which aroused mainly academic concern but relatively little clinical interest, because its therapy and prognosis had a most un favorable outlook. Indeed, it was mostly recognized only at autopsy. Recently this pessimism has radically changed and is disappearing to a rapidly accelerating degree. Many of the scientific contributions at this change in outlook are the result of research in the Far East, first, Japan and then gradually extending to its neighbors. The introduction of experimental hepatocarcinogens by Yoshida more than 50 years ago may have been one of the first important steps. Hepatocellular car cinoma shows a characteristic geographical distribution. With the highest incidence in China, Taiwan, Southeast Asia and sub-Saharan Africa, followed by southern and eastern Europe, while generally the incidence is rather low in western and northern Europe and North and South America.

Over the past 10 years there has been a veritable explosion of knowledge in working in this area are fortunate to meet their bile acid research. Those colleagues from time to time at International Meetings which are often held in attractive parts of the world. The 7th International Symposium on bile acids 'Bile Acids in Gastroenterology' was no exception. It took place in Cortina d'Ampezzo in the heart of the Italian Dolomites, from 17th-20th March 1982. This meeting was organised by a Scientific Committee, with representatives from Italy, the United States and Great Britain, in collaboration with the Italian Society of Gastroenterology. The format of the meeting was somewhat different from that of previous years. In addition to the free communications (verbal and poster presentations) which characte rise many scientific meetings, there was also an Advanced Postgraduate Course on bile acids given by a distinguished international panel of experts. Their contributions form the basis for this timely volume which should be of interest both to basic scientists and to clinical investigators alike. The editors are indebted to Dr Gian Germano Giuliani, Gipharmex SpA, Milano, whose generous support made the meeting possible. They also thank Mr P. M. Lister, Managing Editor, MTP Press Limited and Mrs Veronica Cesari, Italian Society of Gastroenterology for help with the publication of these proceedings. R. Herman Dowling ix 1 Liquid-solid extraction, lipophilic gel chromatography and capillary column gas chromatography in the analysis of bile acids from biological samples K. D. R.

Since the success in chemical induction of cancer in rabbit's ear skin by K. Yamagiwa in 1915, oncologists of the world have come to believe that they can only solve their problems by means of animal experimen tation. The importance of environmental factors became moreevident in 1935 when T. Yoshida and T. Sasaki introduced azodye hepatocarcino genesis in rats. In the domain of the gastrointestinal tract, T. Sugimura has more recently accumulated enough evidence to indicate that locally active chemical mutagens are carcinogenic. In contrast, principal approaches to colorectal tumors have been quite different: emphasis has been placed on gene identification. Long before cancer of the large bowel was recognized, importance of the roles of adenomatosis coli and its familial occurrence attracted the attention of epidemiologists and geneticists. Morphological characteri zation and analysis of hereditary trends of human material have already bad a long history, and recently detailed analysis of genetic material has become feasible in the wake of rapid development in our knowledge of the oncoviruses, oncogenes, suppressor genes, chromosomal and DNA mapping, molecular mutation and so on. lt is true that in colorectal pathology, and in no other field, these areas of research have been explored more extensively and decisively. The identification of previ ously ill-defined lesions such as precancers and benign neoplasms have been improved because sequential changes can be observed in multiple samples spread over a wide area and followed up in due course.

This is a multi-author book on hilar cholangiocarcinoma, written by an international team of world-renowned experts covering topics in their respective areas of expertise. There are altogether 71 authors from 14 countries/regions, mainly Argentina, Australia, China, Germany, Italy, Japan, Korea, Malaysia, Thailand, the Netherlands, the United Kingdom and the United States of America. This book aims to provide an up-to-date, fully referenced text that is as succinct as possible, but as comprehensive as necessary, addressing all topics in hilar cholangiocarcinoma. It provides the latest findings in the rapidly advancing field of hilar cholangiocarcinoma. Controversial aspects are discussed by highly regarded authorities who look at the problem from different perspectives. A helpful list of references is included at the end of each chapter. The extensive use of diagrams, figures and tables makes the text easy to read. This book is primarily intended for clinicians and researchers who are interested in hilar cholangiocarcinoma, including liver surgeons, hepatologists, interventional and diagnostic radiologists, and basic researchers. General physicians, general surgeons, trainees, epidemiologists, hospital administrators, pathologists and instrument manufacturers will also find this book to be a valuable reference work. Editor Lau is currently a Professor of Surgery at the Chinese University of Hong Kong, and an Academician of Chinese Academy of Sciences, China.

Primary Liver Cancer: Surveillance, Diagnosis and Treatment focuses on the many therapies rapidly evolving to assist with controlling hepatocellular carcinoma as well as emerging technologies to assist in early diagnosis as well as prevention. All chapters are written by experts in their fields and include the most up to date information for diagnosis, treatment, surveillance, epidemiology, staging, recurrence and prevention. This volume will serve as a useful resource for clinical gastroenterologists, hepatologists, oncologists, pathologists, and physicians who treat patients with chronic liver disease and hepatocellular carcinoma.