Hepatobiliary & Pancreatic Surgery meets the needs of surgeons in higher training and practising consultants for a contemporary and evidence-based account of this sub-specialty that is relevant to their general surgical practice. It is a practical reference source incorporating the most current information on recent developments, management issues and operative procedures. The text is thoroughly referenced and supported by evidence-based recommendations wherever possible, distinguishing between strong evidence to support a conclusion, and evidence suggesting that a recommendation can be reached on the balance of probabilities. This is a title in the Companion to Specialist Surgical Practice series whose eight volumes are an established and highly regarded source of information for the specialist general surgeon. The Companion to Specialist Surgical Practice series provides a current and concise summary of the key topics within each major surgical sub-specialty. Each volume highlights evidence-based practice both in the text and within the extensive list of references at the end of every chapter. Purchase of a print book also includes a downloadable version of the eBook. An expanded authorship team across the series includes additional European and World experts with an increased emphasis on global practice. The contents of the series have been extensively revised in line with recently published evidence. The contents highlight the increasing use of laparoscopic surgical technique in the management of HPB disease. The contributions incorporate the latest oncological approaches to the management of HPB malignancy.

"Specialty Imaging: Hepatobiliary & Pancreas" provides encyclopedic coverage of the clinical, imaging, and pathologic features of every significant disorder of the liver, pancreas, or biliary system. The book includes anatomy modules, providing a solid foundation, whether normal or variant anatomy, for each disorder. Also included are the latest AJCC staging information with drawings to illustrate all of the stages. With nearly 700 pages, more than 2,300 images, and illustrations, this is the go-to reference for all radiologists, gastroenterologists, surgeons and any physician who deals with patients who have disorders of the liver, pancreas, or biliary system. Let the experts , Dr. Federle, Dr. Jeffrey, and Dr. Tublin guide you through all of the details with easy-to-read bulleted text, tables, and images. Features: numerous full color medical illustrations, state-of-the-art imaging, and pathologic correlation; includes tables and illustrative examples of staging of pancreatic and hepatobiliary malignancies; and features the classic benefits of all Amirsys titles, including time-saving bulleted text, ket facts in each chapter, stunning annotated images, extensive index, and Amirsys eBook Advantage, an online version of the print book with hundreds of additional images, larger images, and fully searchable text.

Dx/Rx: Liver Cancer is a quick and practical reference guide containing all aspects of the diagnosis and therapy of hepatocellular carcinoma (HCC), prognostic and staging systems, clinical management, molecular biology, current controversies, and future insights. Organized into a condensed, bulleted format, this concise reference offers precise and up-to-date information on the epidemiology, classification, diagnosis, treatment, and risk factors for cancers of the liver. Presented in a handy, easy-to-read format, Dx/Rx: Liver Cancer is a must-have resource for oncologists, internists, primary care physicians, and other health care professionals on the ward or in the clinic.

Chronic Hepatitis C virus (HCV) infection is a serious condition affecting over 180 million people world-wide. The virus infects the liver and while it is estimated that 20% of those infected clear the virus spontaneously, the virus persists in the majority of individuals leading to liver fibrosis, cirrhosis, and hepatocellular carcinoma. This book presents topical research in the study of the epidemiology, pathogenesis and treatment of Hepatitic C Virus including: genome-wide association studies regarding HCV infection; hepatic and blood dendritic cell subsets in patients with chronic HCV; bone metabolism disorders in HCV infection; Socs1 involvement in liver damage during HCV infection; asymptomatic low-level HCV persistence; and HCV infection as the leading cause of liver disease in renal transplant recipients.

AnHiBlich des 5. Therapietages der Abteilung fUr Theore tische und Klinische Medizin der Ruhr-Universitat in Bochum wurde von mir das Leitthema "Interdisziplinare Onkologie am Beispiel der Magengeschwiilste" gewahlt. Gerade bei den Magenkarzinomen ist die Bedeutung der interdisziplinaren Onkologie so offenkundig, daB das Inter esse von jedermann an diesem Gebiet vorausgesetzt werden darf. Die Intensivierung des Kontaktes zwischen Hausarzt, Gastroenterologen, Pathologen, Operateur, Radiologen und Chemotherapeuten ist vor aUem im Sinne des Patienten zu fordern. Ziel soUte es sein, eine moglichst familiennahe Behandlung, die sich oft iiber lange Zeit erstreckt, zu ermog lichen. Das Magenkarzinom ist wohl nach wie vor eines der Mali gnome, bei dem die Behandlungsergebnisse am wenigsten befriedigen. Die Heilung beim lokalisierten Magenkarzinom ist bis heute ausschlieBlich chirurgisch moglich, wahrend die zytostatische Therapie noch in der Entwicklung steht. Auch die Ergebnisse des Operationserfolges ist nur durch ver mehrte Friihoperationen, Senkung der Operationsmortali tat, intraoperative Metastasenprophylaxe und zusatzliche Chemotherapie moglich. In diesem Zusammenhang sei besonders auf die Bedeutung des erstkonsultierten Hausarztes bei der Friiherkennung und die Aufklarung der Bevolkerung hingewiesen. So werden wir vieUeicht in Verbindung mit einer Intensivie rung der interdisziplinaren Zusammenarbeit in greifbarer Zukunft die Symptome des Magenkrebses im Vorfeld der Erkrankung besser erkennen, urn nicht immer wieder das zu erleben, was Theodor Storm im folgenden Gedicht als Be troffener zum Ausdruck brachte: VI Vorwort Beginn des Endes Ein Punkt nur ist es, kaum ein Schmerz, Nur ein GefUhl, empfunden eben; Und dennoch spricht es stets darein, Und dennoch stort es dich zu leben."

Die gro~en Fortschritte in der Hepatitisforschung, die zur Entdeckung und Charakterisierung von 5 unterschiedlichen Virushepatitiden f}hrte, erbrachteneue Erkenntnisse f}r die Epidemiologie, Infektiosit{t und zur Pathogenese. Es gelang die Entwicklung eines wirksamen und sicheren Impfstoffs gegen die Virus-B-Hepatitis. Dagegen ist die Therapie der akuten Virushepatitis und chronischen Virus-B, -C- und -D-Hepatitis noch unbefriedigend. Mit der Einf}hrung von Interferon alfa in die Behandlung der chronischen Virushepatitiden haben sich neue therapeutische Ans{tze ergeben, obwohl erst ungef{hr 30-40% der Patienten davon profitieren. Eine Anzahl von sorgf{ltig durchgef}hrten kontrollierten Therapiestudien im In- und Ausland haben inzwischen zu }bereinstimmenden Therapieempfehlungen gef}hrt, die in diesem Buch wiedergegeben werden. In diesem Buch werden die Epidemiologie, Pathogenese, Klinik und therapie sowie die Prognose der chronischen Virushepatitiden einschlie~lich der Nebenwirkung ausf}hrlich beschrieben. Es wendet sich daher an alle [rzte, die gegenw{rtig oder in Zukunft Patienten mit chronischer Virushepatitisbehandeln.

Publisher's Note: Products purchased from Third Party sellers are not guaranteed by the publisher for quality, authenticity, or access to any online entitlements included with the product. An intense, streamlined review for the gastroenterology board exam Gatroenterology and Hepatology Board Review: Pearls of Wisdom, 3e is a unique question and single-answer review for gastroenterology in-service and board exams. The book features about 3,500 questions with only the correct answer provided, reinforcing the answer students need to remember on exam day. Emphasis is placed on distilling key facts and clinical pearls essential for exam success. Features NEW chapter organization by anatomy to help poinpoint areas of weakness FULL COLOR image gallery NEW chapters on Radiography and Endoscopy

Whether You're A Newly Diagnosed Patient, Survivor, Or Loved One Of Someone Suffering From Liver Cancer, 100 Questions & Answers About Liver Cancer, Third Edition Offers Essential And Practical Guidance. Providing Both Doctor And Patient Perspectives, This Completely Updated And Revised Edition Offers Authoritative Answers To The Most Commonly Asked Questions About Liver Cancer Including Diagnosis, Treatment, Post-Treatment Quality Of Life, And Coping Strategies. Written By A Medical Oncologist And A Gastrointestinal Surgeon, With Actual Patient Commentary, 100 Questions & Answers About Liver Cancer, Third Edition Is An Invaluable Resource For Anyone Coping With The Physical And Emotional Turmoil Of This Disease.

This book provides a single reference for all transplant professionals involved in the care of HCV patients who have unique problems not encountered in other liver transplant patients. In the liver transplant community, it is well-known that decompensated cirrhosis from hepatitis C virus (HCV) is the leading indication for orthotopic liver transplantation (OLT) in the United States and most Western countries. Short-term results which initially seemed promising and comparable to other carefully selected liver transplant recipients now appear less encouraging with cirrhosis developing in 10-25% of patients by 5 years. Despite these concerns, there is an increased amount of data which supports re-transplantation in carefully selected patients.

Designed as an easy-to-use and comprehensive reference for the practicing pathologist, "Diagnostic Pathology: Hepatobiliary and Pancreas" is the next highly anticipated title in "The Diagnostic Pathology series" offered by Amirsys. As readers have come to expect from this series, "Diagnostic Pathology: Hepatobiliary and Pancreas is filled with superior medical images, including gross photographs, photomicrographs, and detailed medical illustrations. As with our other Diagnostic Pathology titles, chapters include definitions, terminology, etiologies and pathogenesis, demographics, clinical presentations, therapy, prognoses, radiologic imaging, pathology, and differential diagnoses. The pathologic features are extensively detailed with descriptions of the macroscopic features, microscopic findings, cytopathology (as indicated), and as needed, ancillary studies. The latter include histochemistry, immunohistochemistry, cytogenetics, molecular diagnostics and ultrastructural findings. There are also a variety of quick-reference test data tables, as well as helpful introductory chapters, annotated and illustrated staging templates, and chapters on specimen examination handling. This handsome volume is a veritable one-stop shop for your hepatic, biliary, and pancreatic pathology reference needs.

The Hepatic circulation is unique among vascular beds. The most obvious unique features include the dual vascular supply; the mechanism of intrinsic regulation of the hepatic artery (the hepatic arterial buffer response); the fact that portal blood flow, supplying two thirds of liver blood flow, is not controlled directly by the liver; the fact that 20% of the cardiac output rushes through the most vascularized organ in the body, driven by a pressure gradient of only a few millimeters of mercury; the extremely distensible capacitance and venous resistance sites; the unidirectional acinar blood flow that regulates parenchymal cell metabolic specialization; and the high concentration of macrophagic (Kupffer) cells filtering the blood. The liver is the only organ reported to have regional blood flow monitored by the autonomic nervous system. This mechanism, when dysfunctional, accounts for the hepatorenal syndrome and offers a mechanistic therapeutic target to treat this syndrome. The trigger for liver regeneration is dependent on hepatic hemodynamics so that chronic liver blood flow regulates liver cell mass. In severe liver disease, the whole body circulation is reorganized, by forming portacaval shunts, to accommodate the increased intrahepatic venous resistance. These shunts protect the venous drainage of the splanchnic organs but lead to loss of major regulatory roles of the liver. The development of knowledge of the hepatic vasculature is presented from a historical perspective with modern concepts summarized based on the perspective of the author's four decades of devotion to this most marvelous of organs. Table of Contents: Acknowledgements / Historical Perspectives / Overview / Fluid Exchange / Capacitance / Resistance in the Hepatic Artery / Resistance in the Venous System / Fetal and Neonatal Hepatic Circulation / In Vivo Pharmacodynamic Approaches / Nitric Oxide / Adenosine / Hepatic Nerves / Hepatic Circulation and Toxicology / Hepatorenal Syndrome / Integrative Hepatic Response to Hemorrhage / Blood Flow Regulation of Hepatocyte Proliferation / Multiple Mechanisms Maintaining a Constant Hepatic Blood Flow to Liver Mass Ratio / Pathopharmacology and Repurposing Drugs as a Research Strategy / References

Liver disease is a rapidly growing speciality, and nurses and health care professionals need to have the relevant knowledge and skills to care for patients with liver problems in a safe and effective way. "Liver Diseases" is a comprehensive, evidence-based, practical guide to the nursing care and management of patients with liver disease.

"Liver Diseases" explores a range of liver conditions, including cirrhosis, portal hypertension, alcoholic liver disease, viral hepatitis, autoimmune hepatitis, Wilson's disease and acute liver failure. It looks at the anatomy & physiology of the liver, assessment of liver function and diagnostic studies, acute and chronic liver disease, pregnancy related liver disease, liver transplantation and infectious liver diseases. For each condition the epidemiology, complications and nursing management are provided, along with illustrative case studies and further reading. "Liver Diseases" is an invaluable tool for all nurses and health care professionals working with people with liver disease.
SPECIAL FEATURESThe first UK book on care of the liver from a nursing and healthcare perspectiveWritten by a well-respected and renowned author in the fieldCovers a wide spectrum of liver diseases, with relevant nursing management guidelinesWith case studies, further reading and illustrations throughout

This book is highly commended and won the Gastroenterology, BMA Awards 2007. This lavishly illustrated text provides you with all of the information necessary to effectively diagnose and confidently sign out hepatobilary tissue samples. An invaluable aid to pathologists at all levels of training and practice, this book covers the full range of both benign and malignant lesions of the liver and biliary tract. All entities are accompanied by carefully chosen photographs of outstanding quality. Summary tables, diagnostic flow charts, and analytic tables give you all the information you need for rapid interpretation and accurate diagnosis.

Busy clinicians need easily accessible information falling into two broad categories: diagnosis and management of patients with particular groups of symptoms; and comprehensive information on defined clinical problems. With this in mind, the Oxford Handbook of Gastroenterology and Hepatology has been structured in a unique way. The first section covers approaches to clinical problems detailing 29 of the most common problems in GI medicine, including infectious disease and gastrointestinal problems in developing countries. A key section of the handbook is a unique A-Z compendium of the specialty which includes information on 100s of topics in gastroenterology, from Abetalipoproteinaemia to Zieve's syndrome. Colour coded links enable readers to find information in related chapters quickly. Further sections include emergencies, and commonly used drugs used in gastroenterology and hepatology, with emphasis on practice tips and common complications. The result of this new approach is a handbook which is practical and informative, while being a pleasure to use.It is an essential guide to the management of common conditions and will be invaluable to all those involved in the care of patients with gastrointestinal disease.

""Hepatitis B" is one of the world's most common viruses--and one of the top ten killers. Unlike much else in our often gloom-filled world, it looks likely that HBV will be effectively controlled, and possibly eradicated, within the next decade. If so, Baruch Blumberg will deserve a large share of the credit. But this book is much more than a scientific success story. It vividly conveys the existential adventure of science: the surprises, disappointments, exhilaration, and dull routines whose results serve us all so well."--Robert M. May, President of the Royal Society

"A thoroughly engaging history of one of the most important medical discoveries of the century, recounted with keen insight, lively wit, and remarkable humility. Rarely is one afforded such an opportunity to learn firsthand from a world-class scientist how new paradigms in biology result from relentless questioning and intellectual passion."--Jerome Groopman, Professor of Medicine, Harvard Medical School, author of "The Measure of our Days"

"A pioneer in the field, Blumberg has a unique insight and perspective. He clearly presents a superb account of the story of hepatitis B virus discovery and argues, interestingly, how such a discovery can mirror the general process by which scientific ideas evolve, including the contributions of chance, good fortune, intelligence, and hard work."--Tonse N. Raju, Professor of Pediatrics, University of Illinois at Chicago, author of "The Nobel Chronicles"

"Baruch Blumberg, Nobel-prize winner for his discovery of the hepatitis B virus, has never before woven all the strands of the story into a full tapestry. What makes the story doubly fascinating is the world-wide public healthimportance of hepatitis B, as much of a killer as AIDS. Blumberg is an eloquent writer giving a fascinating account. General readers and experts alike will find this an enjoyable book, not least for the vivid touches that feel first-hand."--Jenny Stanton, History Group, London School of Hygiene and Tropical Medicine

Surgery of the Liver, Bile Ducts and Pancreas in Children describes the modern approach to the diagnosis, management and surgery of childhood conditions of the liver, bile ducts and pancreas. The first edition was recognised worldwide as the textbook in this field; the second was expanded to include pancreatric diseases in children. This third edition has a new editor team from Kings College Hospital and the Children's Memorial Hospital in Chicago, both of which have considerable international reputations in diseases of the liver. It has been expanded and updated by an team of international experts.Key features: High qualilty operative line drawing will aid understandingEditorial team from the world-leading paediatric liver centers of Kings College Hospital and the Children's Memorial Hospital, ChigacoEach chapter is written by an expert of international renownFully revised section on Transplant SurgeryNow includes fully searchable ebookSurgery of the Liver, Bile Ducts and Pancreas in Children will be an invalulable resource for paediatric surgeons, gastroenterologists, paediatricians, nurses and anyone involved in the surgical care of children with liver, biliary, or pancreatic disorders, whether based at a specialist children's hospital or elsewhere. It will also appeal to trainees with limited experience in this area.

This book is a celebration of the emergence of knowledge in the field of pediatric hepatology and is written for primary care clinicians to help update their knowledge of the field. The current and future shortage of pediatric gastroenterologists and hepatologists necessitates steady, rejuvenated information on liver and gastrointestinal disorders for primary care clinicians as they care for children and adolescents with complex hepatologic/gastroenterologic dilemmas and disorders. In view of this shortage and the rapidly increasing knowledge in pediatric gastroenterology as well understanding indications for referral to pediatric gastroenterologists in the 21st century, au courant assiduous information aimed at primary care clinicians in these areas becomes increasingly important.

- Moderne Diagnostik per Ultraschall, CT und MRT

- Behandlungsverfahren, interventionelle Techniken wie Kryotherapie, Radiofrequenztherapie und laserinduzierte Thermotherapie (LITT)

This book discusses the diagnosis, treatment and management of liver disease. Chapter One reviews hepatic hydatidosis. Chapter Two explores the diagnosis, natural history, and management for patients with chronic hepatitis C (CHC). Chapter Three discusses scientific evidence that explains the relationship between metabolic syndrome, non- alcoholic fatty liver disease (NAFLD) and psoriasis and the treatment strategy for this co-morbid condition. Chapter Four examines the pathophysiology and treatment of liver cirrhosis. Chapter Five reviews surgical strategies to push up resection limits in liver disease and liver failure after surgery.

La (TM)ecografia A] una metodica particolarmente indicata per guidare le procedure interventistiche. La (TM)ecografia interventistica viene spesso impiegata per la diagnosi di malattia. Notevoli e rapidi avanzamenti tecnologici hanno portato alla sempre maggiore diffusione delle procedure interventistiche ecoguidate, modificando in modo significativo le strategie diagnostiche e terapeutiche di molte patologie. Il volume presenta una concisa panoramica delle piA comuni procedure interventistiche percutanee e si propone come guida rapida per il radiologo e la (TM)ecografista ai quali, sempre piA frequentemente, viene richiesta la (TM)esecuzione di procedure interventistiche su fegato, vie biliari e pancreas sia per fini diagnostici che terapeutici. La trattazione A] estesa anche ad altre metodiche di imaging ad integrazione, completamento o quale alternativa alla guida ecografica. Se da un lato A] infatti sempre piA sentita la necessitA di svolgere il ruolo di interventista, dalla (TM)altro risulta indispensabile la competenza nella scelta e nella (TM)impiego della metodica piA adeguata per la corretta realizzazione della procedura richiesta in relazione allo specifico quesito (diagnosi, terapia e follow-up).

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.

The recently published article "The Burden of Liver Disease in Europe: A Review of Available Epidemiological Data" provides a few figures on the enormous problem that liver disease poses for Europeans. Liver disease is estimated to cause 170,000 deaths annually in Europe, 47,000 of which are attributed to liver cancer; 0.5%-0.7% of the European population is affected by chronic hepatitis B; and prevalence rates of hepatitis C virus (HCV) infection in the last decade in the European population ranged from 0.13 to 3.26%. These HCV-infected populations will develop complications in the years to come. It is of great concern that about 90% of people in Europe infected by viral hepatitis are unaware of their status. Alcoholic and non-alcoholic fatty liver disease (NAFLD) must also be added to the picture. NAFLD is becoming a major concern with the increasing incidence of obesity and type 2 diabetes in Europe. The burden of liver disease is not less pessimistic in North America, Asia and the rest of the world.

Hepatitis B virus (HBV) infection is a problem of global health importance and represents a significant cause of morbidity and mortality world-wide. HBV can be transmitted parenterally, sexually and perinatally. Despite progress on prophylaxis, diagnostic and treatment of HBV infection, it remains one of the major causes of chronic liver disease, cirrhosis or hepatocellular carcinoma. This book presents a compilation of current research including such topics as Hepatitis B and dialysis; Hepatitis B virus infection among middle school students in South Brazil; genotyping and management of chronic Hepatitis B; the risk assessment for Hepatitis B infection and its role in hepatocellular carcinoma; and silencing Hepatitis B virus replication with antiviral Pri-Mir shuttles generated from liver-specific Pol II promoters.

Rapid advances on molecular studies, manipulation of the mouse genome, the development of a number of animal models, and using these in studies of nonalcoholic fatty liver disease (NAFLD) have provided important insights into the pathogenesis of this relatively common disorder. One of the most crucial advances was to recognise the links among obesity, insulin resistance, inflammation and NAFLD. A growing body of literature has shown that insulin resistance and its liver-related consequence, NAFLD, could be the result of generalised inflammation. Genetic and behavioral factors contribute to increased visceral adipose tissue where increased oxidative stress and lipid peroxidation may contribute to dysregulated production of adipocytokines, fatty acids, and bioactive lipids. This chain of these events may contribute to local and peripheral insulin resistance, a central underlying pathophysiological process that may both cause and result from increased peripheral lipolysis and elevated free fatty acid concentrations in the circulation. Abnormally elevated free fatty acids taken up by organs other than adipose tissue, such as liver and skeletal muscle, contributes to steatosis of these organs (ectopic lipogenesis). Increased muscle and hepatocellular lipid content provides substrates for oxidative stress and lipid peroxidation, and also promotes insulin resistance in both liver and muscle by disturbing their downstream insulin signaling cascades. Insulin resistance further increases peripheral lipolysis in adipose tissue, further elevates circulating free fatty acids, inhibits hepatic fatty acid a-oxidation and increases de novo synthesis of both fatty acids and triglycerides in the liver. Excessively produced triglycerides in the liver are either stored as fat droplets or secreted into the plasma as very-low-density lipoproteins. If this complex mechanism of hepatic fat synthesis and secretion capacity is overwhelmed, excessive triglycerides accumulate within the hepatocytes and manifests as NAFLD. A fatty liver is sensitive to hepatocellular injury and sustained injury can manifest as nonalcoholic steatohepatitis (NASH), NASH-associated cirrhosis, and NASH-associated hepatocellular carcinoma. Specific depletion of hepatic natural killer T cells with consequent proinflammatory cytokine polarisation of liver cytokine production might be one reason for this increased hepatic sensitivity against various stimuli. Only a minority of patients with NAFLD have the necroinflammatory changes of NASH. The development of NASH in patients with NAFLD may be the consequence of secondary abnormalities such as injured and dysfunctional mitochondria, generation of reactive oxygen species with down-regulation or consumption of antioxidants causing oxidative stress and lipid peroxidation, increased activity of cytochrome P450 2E1, disturbed production of adipocytokines, and the effects of gut-derived cytotoxic products. The dynamic interplay of these processes in the pathogenesis of NAFLD remains incompletely understood and is an area of active research.