Liver disease is an increasingly common cause of mortality, and its management is often complex and challenging. Endoscopy has in recent times undergone a period of rapid progress, with numerous novel and specialized endoscopic modalities that are of increasing value in the investigation and management of the patient with liver disease. As the technology in endoscopy expands, both as a diagnostic and interventional procedure, so does the role of the endoscopist in liver disease. This full colour book and companion website offer a comprehensive guidance as to when, why, and how to perform endoscopy to best manage your patients. * Brings together two key areas liver disease and endoscopy into one expert clinical textbook * Covers the entire spectrum of clinical problems that gastroenterologists and endoscopists face while managing patients with liver disease * Includes the latest management guidelines from the key international societies, such as the ASGE, AASLD, EASL and BSG * Well illustrated with over 200 high-quality colour images *20 high-quality videos illustrating optimum endoscopy practice, all clearly referenced in the text * Outstanding UK- and US-led expert editor team with a wealth of clinical experience An indispensable tool for all gastroenterologists, hepatologists and endoscopists, Endoscopy in Liver Disease is perfect for learning how to perform endoscopy safely and effectively in the patient population with liver disorders.

A practical, portable handbook, newly updated with nearly 100 color images and figures, The Little GI Book: An Easily Digestible Guide to Understanding Gastroenterology, Second Edition is an invaluable resource for anyone new to the world of gastroenterology and hepatology. Featuring new information on the latest advancements in gastroenterology and hepatology and written in a friendly, conversational style, The Little GI Book will help readers learn the core concepts of digestive health and disease and absorb important information without a hiccup. Author Dr. Douglas G. Adler provides a comprehensive, soup-to-nuts guide to gastrointestinal anatomy, physiology, disease states, and treatment. With new color images throughout, The Little GI Book guides the reader through the entire gastrointestinal tract, starting at the top with the esophagus, ending at the bottom with the colon and rectum, and covering everything in between: the stomach, small intestine, liver, pancreas, bile ducts, and gallbladder. The Little GI Book is an indispensable pocket guide for residents, students, nurse practitioners, office staff, industry sales force, and anyone who works in the GI industry but isn't a gastroenterologist.

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.

The topic of alcohol and the liver is long overdue for re-evaluation. The authors of this book have clearly taken up this challenge. Human interest in alcohol dates back to the Neolithic period (circa 10,000 BC). Only a small amount of alcohol is found naturally in food. Therefore, humans have yet to adapt to the high quantities of alcohol consumed daily by alcohol abusers. Alcohol is a simple carbohydrate and is metabolised as a fuel. However, unlike more naturally occurring carbohydrates such as glucose, the pathways for its metabolism are not subject to the same checks and balances. Ethanol oxidation reduces NAD+, which starves reactions that depend on this substrate. This accounts for the accumulation of fat in alcoholic steatosis. Alcohol metabolism generates significant amounts of reactive oxygen species (ROS), which damages mtDNA and subsequently mitochondrial integrity. The authors provide several lines of evidence that link the clinical picture of alcoholic liver disease with mitochondrial damage. Other important topics highlighted in this book include histo-pathological aspects of the disease. Clinical assessment of nutrition and vitamin supplementation is addressed as well. The book concludes with the highly topical and controversial aspect of liver transplantation in patients with alcoholic liver disease.

Bile acids (BAs) have received considerable attention as the key players of systemic metabolism. In the past, bile acids were known to play important roles in absorption of cholesterol, fat-soluble vitamins, and lipids. However, the new roles of bile acids as signaling molecules have been recognised in the last two decades because of discovery of bile acid receptors such as nuclear hormone receptor farnesoid X receptor (FXR) and the membrane receptor G-protein-coupled bile acid receptor 5 (Gpbar1, TGR5). As the metabolic regulators, BAs play pivotal roles in the regulation of bile acid, cholesterol, fatty acid, lipoprotein synthesis, glucose metabolism and energy metabolism. Therefore, BAs, bile acid derivatives, and bile acid sequestrants are potential therapeutic agents for treating a number of metabolic disorders, especially those related to the metabolic syndrome. The first chapter of this book summarises the basic information of bile acids but focuses on its new functions in different diseases. The next chapter discusses mixed micelles of bile acid salts and phospholipids starting from historical Smalls disc model up to the advanced version as "stacked disk" and "radial shell". The final chapter studies bile aspiration as a host factor for modulating chronic respiratory infection.

Non-alcoholic fatty liver disease, or NAFLD, represents a spectrum of pathologic liver histologic findings ranging from the simple accumulation of fat, known as steatosis, to nonalcoholic steatohepatitis and cirrhosis. It is estimated that NAFLD in all of its forms would have a 20% prevalence worldwide, but the evidence suggests a higher rate for developed countries, exceeding 30% for the US general population. Major risk factors for NAFLD, such as ageing, obesity and insulin resistance, are projected to increase in the following decades, causing the prevalence and relevance of NAFLD to rise in the future. In obese populations and type 2 diabetes patients, the prevalence of this disease exceeds 70%. NAFLD has been called the "silent epidemic" for its lack of symptoms, relatively complex diagnosis and its deleterious effects. The association between NAFLD with cardiovascular diseases, energy metabolism disorders and polycystic ovarian syndrome has promoted the inclusion of this liver pathology within the metabolic syndrome. From a biochemical point of view, current evidence suggests the existence of a bidirectional causal relationship between NAFLD and oxidative stress, where various alterations energy metabolism and important inflammatory components are involved. An abnormal glucose and fatty acid metabolism lead to glucotoxicity and lipotoxicity, respectively, which promote oxidative stress through different pathways. Oxidative stress induces the expression of pro-inflammatory mediators, including transcription factors and cytokines, which trigger an immune activation, a key step in the transition from simple steatosis to steatohepatitis. An early diagnosis and optimal therapy are essential for NAFLD treatment. First-line treatment of NAFLD focuses on lifestyle changes. Weight reduction through an increase in physical activity and/or nutritional management is considered safe and effective, but pharmacological management of common comorbidities such as hyperglycemia, dyslipidemias and hypertension are also essential. The key role of oxidative stress in NAFLD pathophysiology suggests that antioxidant interventions based in natural substances such as polyphenols would be effective. Recently, it was shown that the antioxidant properties of these compounds are beyond their free radical scavenging. This book presents an update of research advances contributing to a better understanding of relevant clinical models of NAFLD, particularly, the disorder in energy metabolism and the role of oxidative stress. It also highlights the clinical and pathophysiological association between NAFLD and the metabolic syndrome, and presents an overview of current diagnosis and treatment and the future avenues for the management of this disease.

Dr. Levy has secured the field's top experts to offer the latest clinical reviews on cholestatic liver disease. The issue will include articles devoted to The Gut-Liver Axis; Update on Genetics in Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis; New thoughts on IgG4 Associated Cholangitis; Cancer Risk and Surveillance in PSC; Novel Therapies for PBC; and Liver transplantation for Cholestatic Liver Diseases, to name a few. Dr. Levy's issue will be the most current authority on cholestatic liver disease.

Over the past few years, epidemiological studies have revealed that there is an increase of life threatening liver diseases worldwide. It becomes increasingly clear that developments in this field are moving so rapidly toward the creation of new drugs against these maladies. Numerous research articles and books have been published on various aspects of toxicities, symptoms, managements and health implications of the liver. Consequently, a catalogue of collective information of toxicities, various features of natural products, and remedies for the prevention of toxicities is needed. This book deals with the toxicities in organs like the liver and the role natural products have in the preventing these ailments. It also analyses trends in the processing of natural products by using nanotechnology and their health implications. The main purpose of this book is to exhibit relevant, modern information on hepatotoxicity, its symptoms, and treatments presented by internationally recognised experts in the field. Therefore, it is our belief that this book has covered some of the most interesting aspects of research in liver diseases and provides a trustworthy source of current information in this area of research which should prove useful to the scientists interested in this discipline throughout the world. This collection will interest a variety of other scientific disciplines including toxicology, genetics, medicine and pharmacology, as well as drug and food sciences. We hope that our readers will find this volume to be a delightful addition to their personal libraries, laboratories and offices. Additionally, it can be used as a required or recommended text for related courses taught at colleges and universities levels.

Variceal Hemorrhage provides an update of the evidence concerning several aspects of variceal hemorrhage. The book features new information on natural history, diagnosis of esophageal varices, assessment of the risk of bleeding and identification of high risk groups and patients who may benefit or be harmed from different treatments. The volume also presents a critical analysis of the different steps in the management of acute variceal bleeding. Authored by the most prominent world experts in their areas of expertise, Variceal Hemorrhage serves as a very useful reference for gastroenterologists, GI surgeons, residents in internal medicine and physicians dealing with and interested in the different aspects of this severe medical emergency.

Containing a selection of teaching tools for general anatomy and pathology, this work, with flip charts, offers an overview and understanding of the subject matter. It is useful for student or patient education. It is suitable for the home, the school library, or the physicians office and can be written on by a dry marker.

Gastroenterology and Hepatology Lecture Notes is a comprehensive yet easy-to-read overview of luminal gastroenterology and hepatology. Covering the epidemiology, causes, clinical features, investigation, treatment and prognosis of all the main gut and liver conditions, it is ideal for both exam preparation and fact finding. Key features include: A full range of new illustrations, including clinical photographs and scans, that clearly demonstrate signs and symptoms Sections on anatomy, physiology, pharmacology, and epidemiology written to enhance understanding of clinical features Essential information highlighted throughout the text Case-based self-assessment for each chapter helps retention of knowledge and puts it in its clinical context A new section of best answer MCQs New chapters on inflammatory bowel disease and different diagnosis of the upper GI tract Includes a companion website at www.lecturenoteseries.com/gastroenterology featuring 16 in-depth case studies Whether learning the basics of the gastrointestinal system, starting a general medical or gastroenterological placement, or looking for a quick-reference overview to revise key concepts, Gastroenterology and Hepatology Lecture Notes is an ideal resource for medical students, MRCP or FRACP candidates, and junior doctors.

International researchers summarize the current understanding of peptic disease and trace the development of a novel new drug for peptic disease therapy-sucralfate. Contributors present laboratory research along side data from clinical trials as well as from the practice of medicine. Articles discuss the history of sucralfate's development, mechanisms of action, clinical efficacy, and future directions for research. This volume will be of interest to scientists and clinicians working in gastroenterology and gastrointestinal physiology.

This field has shown tremendous growth in recent years, primarily due to the recognition that drug-induced liver disease is the most common cause of liver failure and one of the major contributors to the withdrawal of drugs developed by the pharmaceutical industry. Drug-Induced Liver Disease, 3rd edition is a comprehensive reference that covers mechanisms of injury, diagnosis and management, major hepatotoxins, regulatory perspectives and much more. Written by highly respected authorities, this new edition is an updated and definitive reference for clinicians and scientists in academia, the pharmaceutical industry and government settings. This book contains 4 new chapters on key topics in the area and provides a current and extensive review of the latest developments concerning the toxicology, pharmacology, genetics and immunology of drug-induced liver disease.

A multi-authored reference work written by leading clinical, academic and industry experts in drug-induced liver disease.

Contains four new chapters on key areas in the field, including one on worldwide drug-induced liver injury networks.

Each chapter has been updated to address the latest research and findings in the field and 16 new chapter authors have been added to this new edition.

Includes coverage of the basic, clinical and practical aspects of drug-induced liver disease to provide the single most comprehensive reference on the subject. "

Clinical Dilemmas in Liver Cancer follows the successful format of the other books in the Clinical Dilemmas series, with each chapter focused on a specific dilemma, or issue facing doctors in their day-to-day job, and providing them with practical clinical information and help to better assessment and treat their patients - in this case patients suffering from liver cancer, the third commonest cancer in terms of mortality worldwide.

Chapters feature up-to-date information on the basic mechanisms, epidemiological risk factors, screening and surveillance strategies, diagnosis and treatment. It is an extremely practical and clinically-orientated book, and as most patients around the world present with advanced disease, a main focus is on the most recent advances allowing early diagnosis and use of locoregional and systemic therapy, surgery, transplantation and combination therapies. Each chapter is authored by an international expert in the relevant area.

Hepatology is an important specialty with diseases and complications related to viral hepatitis and alcohol being the main reason for seeking specialist advice. On most general medical rotations and on most surgical wards there are patients with hepatological problems. "Hepatology: Clinical Cases Uncovered" contains clinical presentations with real-life patient cases and outcomes as seen on the wards and in exams, and leads students through a practical approach to diagnosis and management of hepatological disease.

Following a question and answer approach, including self-assessment material and a 'refresher' section on the basic science, "Hepatology: Clinical Cases Uncovered" features investigations and the treatment options available for patients presenting with hepatological problems. Difficult concepts are clarified and relevant links are made between pathology and clinical presentation.

"Hepatology: Clinical Cases Uncovered" is ideal for medical students, junior doctors on the Foundation Programme, GP trainees, residents, specialist nurses and nurse practitioners. The book is also an ideal refresher for hepatology or gastroenterology trainees at the beginning of their specialist training programme

A cutting-edge review of the latest findings on key scientific topics and the best strategies for evaluation and management of portal hypertension in the clinic. Writing in an easy-to-read style, the authors review its pathobiology, the progress being made in its experimental understanding, the methodologies to assess it in humans, the treatment of its complications (esophageal varices, ascites, and hepatorenal syndrome), and its treatment in special circumstances (during pregnancy, in children, or when the portal vein is blocked). They also provide in-depth coverage of the pros and cons of the various therapeutic choices available to the clinician managing patients with complicated portal hypertension.

The new edition of this pocket guide has been fully updated to cover the common manifestations of liver disease, how to treat them and when to refer patients on to specialist centers. New chapters on Acute Liver Failure, Nutrition and Congenital Heart Disease have been added to reflect the key issues in management of liver diseases. The book outlines the common clinical liver diseases such as fatty liver disease and viral hepatitis, among others, and their current up to date management. Written by experts in the field and containing figures and tables, as well as case histories and questions, this is an enjoyable and reader-friendly book for the busy physician. With its authoritative, didactic style and short chapters, it covers the common presentations and complications of liver disease, and how to deal with them. Given the increasing prevalence of liver disease in the UK and Worldwide, this is an ideal reference book for primary care physicians, doctors in specialist training, clinical nurse specialists and for gastroenterologists, who see patients with liver disease in their working lives.

Cardio-Hepatology: Connections Between Hepatic and Cardiovascular Disease provides a direct relationship between the cardiac and hepatic pathologies providing the link between the heart and liver and showing how liver diseases predispose to impairment in heart functioning and vice versa. Considering the growing number of patients living (and living longer) with heart failure and/or congenital heart disease, it is important to know when and how to test for liver disease in this population, how to interpret abnormal test results, and what management is appropriate. Coverage includes what should be done for patients to limit, avoid, or postpone the impairment in the liver functioning induced by heart diseases and the impairment in the heart functioning induced by liver diseases, on the basis of scientific-exposed evidence and pathophysiology knowledge. This comprehensive, extended review of the medical literature is perfect for researchers interested in the connection between cardiology and hepatology as well as clinicians making therapeutic decisions for patients suffering from heart or liver chronic diseases.

Signaling Pathways in Liver Diseases, Third Edition again provides hepatologists and hepatology researchers with an expert overview of the complex and novel cellular/extracellular signaling pathways in the liver, and their role in liver diseases. The last few years have seen a great number of developments in this field, which in turn have led to new opportunities for innovative treatments; however, the intricacy of these pathways and their interactions continue to provide a real challenge for clinicians. This outstanding book compiles the emerging knowledge into a single expert resource, cataloguing and organizing it into an accessible and understandable format. With increased focus on the comprehension of cellular mechanisms involved in steatohepatitis, cirrhosis, and liver tumors, which has led to changes in the management of these diseases, this new edition also sees the introduction of exciting new chapters on key emerging areas such as: * Autophagy * Notch Pathway * P13K/PTEN Signaling in Liver Diseases * Sirtuins * Hepcidin and Iron * Epigenetic Regulation of Hepatic Stellate Cells and Liver Fibrosis * Oxidative Stress and Signaling in the Liver. Professors Dufour and Clavien have assembled an all-star cast of chapter authors, each of whom has provided clear and appropriate illustrations to reinforce the text, with a key points box offering a concise and handy summary. Self-assessment questions and answers allow the reader to test their own knowledge. Signaling Pathways in Liver Disease, Third Edition is the perfect educational and reference tool to bridge the information exchange between the laboratory, the clinical ward, and the operating room, and an essential tool for the modern-day hepatologist.

This atlas describes and illustrates in detail the surgical procedures employed in laparoscopic anatomical liver resection, according to tumor location. The surgical approach and techniques are explained for each type of laparoscopic liver resection based on the involved anatomical segment, section, and hemi-liver. Attention is also drawn to potential complications and the means of preventing and managing them. Beyond anatomical liver resection, guidance is provided on non-anatomical resections that do not pay regard to segmental, sectional, or lobar anatomy. The coverage is completed by the inclusion of useful information on instruments and energy devices as well as the basic skills required for laparoscopic liver resection. In presenting a clear practical approach to each laparoscopic anatomical major and minor resection, the Color Atlas of Laparoscopic Liver Resection will be an invaluable guide for trainees. In addition, it will equip more experienced surgeons with much useful information that will enable them to further improve their technique.

This book is serving the surgical trainee and the experienced transplant surgeon as a compendium of the various topics in split liver grafting. It is comprised of articles by faculty members of the first International Course on Split Liver Transplantation. Covering the main aspects of Split Liver Transplantation, this excellent volume helps livertransplant-surgeons select the best technique and getting aware of pitfalls. Detailed instructions on the different procedures are round off by an overview on technical development, status quo as well as the experience to date.

This book presents the latest application of digital medical imaging technology in biliary tract surgery, including three-dimensional visualization preoperative evaluation, preoperative surgical planning, and simulated biliary surgery. Digital surgical diagnosis and treatment of cholecystolithisasis, bile duct stones, hepatolithiasis, gallbladder cancer, and bile duct cancer is described in details with more than 900 illustrations. Written by experts with wealthy of clinical experience, it will be a useful reference for general surgeons, as well as practitioners in related disciplines.

This book provides a comprehensive overview of the diagnosis and management of diseases of the biliary tree. Topics covered include: congenital biliary abnormalities, genetic cholangiopathies, autoimmune cholangiopathies, inflammatory and drug-related cholangiopathies, and cholangiocarcinoma. Given their particular importance (even for clinicians working with adults), pediatric conditions are also examined. In addition, a special section is devoted to pregnancy and diseases of the biliary tree, and to transplants and diseases of the biliary tree. Each chapter offers up-to-date information on the management of the diseases discussed. Moreover, the book addresses new treatments for autoimmune cholestatic liver diseases, reflecting the new therapeutic targets that have recently been discovered. Examples include farnesoid X receptor (FXR) and peroxisome proliferator-activated receptor (PPAR)-agonists, together with new drugs that affect the composition of bile flow. Given its scope, the book offers a valuable guide for a broad range of practitioners.

This book provides up-to-date information on all aspects of gallbladder disease. After an introductory section on laboratory findings, pathology, and diagnostic methods, it focuses on specific conditions and their management, covering gallbladder stones, acalculous cholecystitis, gallbladder lesions associated with IgG4-related disease and with anomalous pancreaticobiliary ductal union, and dyskinesia of the gallbladder. Moreover, it discusses incidental gallbladder carcinoma in detail, including epidemiology, risk factors, gene mutations, diagnostic imaging methods and treatment modalities. The book also features a section exploring important current issues, such as the diagnosis and therapy of polypoid lesions and gallbladder wall thickening, and the role of prophylactic cholecystectomy in patients with concomitant gallstones following removal of common bile duct stones by ERCP. It also compares endoscopic gallbladder drainage with percutaneous transhepatic gallbladder drainage. Lastly, the book offers stimulating future perspectives.

This is the second of two volumes that together provide a comprehensive analysis of the embryology, normal anatomy, and pathology of the liver and intrahepatic biliary tract as seen on modern diagnostic imaging techniques. In this second volume, readers will find comprehensive description and illustration of the imaging appearances of tumoral pathologies, both in the "normal liver" and in the context of chronic liver disease and liver cirrhosis. In addition, the imaging findings in relation to different treatment approaches are presented, with extensive coverage of imaging of tumor response and post-treatment changes. The authors are world-leading experts in the field, and the book will be an ideal reference for all members of the radiology community, from residents to experts. It will also aid clinicians during their daily practice.