Surgical Challenges in the Management of Liver Disease最新文献

{"title":"Use of Intraoperative Ultrasound (IOUS) in Liver Surgery","authors":"A. Yahya","doi":"10.5772/INTECHOPEN.81175","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.81175","url":null,"abstract":"Over the last many years, diagnostic imaging has grown from a state of infancy to a high level of maturity. The various imaging modalities were developed over the last 50 years. Ultrasonography is one of the valuable tools in diagnosis of many diseases for a long time. It replaced X-ray in the diagnosis of many different diseases. It is noninvasive and has no complications if used many times in the day even if it is safe during pregnancy. The use of ultrasonography was spread over the years in all branches of medicine. It is promptly used in emergency medicine. Its use was introduced during operations. It showed excellent results when used for the assessment of liver tumors either primary or secondary liver tumors during open surgery and laparoscopy. The use of high-frequency ultrasound probe intraoperatively will nullify the abdominal wall and bowel gas effects on the result.","PeriodicalId":202352,"journal":{"name":"Surgical Challenges in the Management of Liver Disease","volume":"51 Pt 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126231076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Damage Control in Liver Surgery","authors":"A. Yahya","doi":"10.5772/intechopen.80817","DOIUrl":"https://doi.org/10.5772/intechopen.80817","url":null,"abstract":"Damage control surgery is an old type of surgery practiced for many years to save the lives of badly injured patients. Damage control was first practiced in the American navy where a damaged vessel would receive minimal repair to keep it afloat. This translates to the field of medicine where minimal surgery is performed to save the life of a patient, and minimal action is taken to avoid major ailments, including hypothermia, acidosis, and coagulation defects during major trauma. Before World War II damage control surgery was popular, but later this type of surgery was abandoned. However, with a better understanding of the physiology of trauma and a revision of the outcome of badly injured patients, surgeons have reverted to damage control surgery, for example the packing of bleeding organs such as the liver and the controlling of sepsis, rather than taking patients to intensive care for further assessment. Damage control surgery has many benefits for badly injured patients and improves their chances of survival.","PeriodicalId":202352,"journal":{"name":"Surgical Challenges in the Management of Liver Disease","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134413549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholangiocarcinoma","authors":"Samuel Romeo Obiekwe, Nathaly Suzett De La Roca, J. Saric","doi":"10.5772/intechopen.81326","DOIUrl":"https://doi.org/10.5772/intechopen.81326","url":null,"abstract":"","PeriodicalId":202352,"journal":{"name":"Surgical Challenges in the Management of Liver Disease","volume":"322 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116106487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introductory Chapter: Hepatic Surgery","authors":"G. Tsoulfas","doi":"10.5772/intechopen.83638","DOIUrl":"https://doi.org/10.5772/intechopen.83638","url":null,"abstract":"Hepatic surgery represents one of the more challenging and exciting areas of surgical practice for a variety of reasons. It combines surgical technical expertise with the management of diseases of one of the most vital and elaborate organs of the human organism. Specifically, the liver with its multitude of functions ranging from nutrition, production of energy, clearing and metabolism of a variety of substances and medications, control of the coagulation system, to name a few, represents a human factory with a complex anatomy and physiology. Its various functions make it a central player in a variety of diseases, where irrespective of their benign or malignant nature, can pose significant threats to the whole organism. The main insults faced may include abdominal trauma (with the liver being the second most injured organ), genetic abnormalities, infections, metabolic alterations, and malignancies. The latter can be either primary (hepatocellular carcinoma, cholangiocarcinoma, and hepatoblastoma) or secondary (metastatic hepatic disease from colorectal, neuroendocrine or non-neuroendocrine, and non-colorectal primary). The common feature in all of these diseases is the significant threat that they pose to the human body, as well as the fact that from the multitude of available treatments, surgery is by far the most successful, yet fraught with possible complications and even the possibility of death. This interesting mix allows us to understand the important and challenging nature of hepatic surgery. The liver surgeon needs to possess deep knowledge of hepatic and human physiology, hepatic anatomy, and surgical skill that is a combination of dexterity and patience. This book with chapters covering the whole spectrum of hepatic surgery represents the cumulative effort of a very experienced group of liver specialists who offer us their distilled experience in areas covering hepatic anatomy with all its significant and often critical variations, an overview of some of the more challenging types of hepatic cancers (such as cholangiocarcinoma), a description of some of the more demanding surgical procedures (such as the extended right hepatectomy), the importance of technology as an extension of the surgeon’s eyes and hands (intraoperative hepatic ultrasound), the true meaning of damage control hepatic surgery (typifying the union of understanding hepatic physiology and surgical acumen), and a description of the molecular pathways involved in the evolution and management of liver disease. The latter carries special weight as we live in the era of precision medicine and patient-targeted treatments. As such, the surgeon should be able to understand the molecular identity of various diseases and how to incorporate that in daily surgical practice. We must learn neither to fear, nor to worship new technology, but rather to objectively and accurately evaluate it and assess its use, and","PeriodicalId":202352,"journal":{"name":"Surgical Challenges in the Management of Liver Disease","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123686058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver Transplantation in China","authors":"Yingzi Ming, Zhuang Quan, Baoren Tu, Gangcheng Kong, Hao Li, Ying Niu, Bo Peng, Junhui Li, Meng Yu, Min Yang","doi":"10.5772/INTECHOPEN.81230","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.81230","url":null,"abstract":"Liver transplantation has been developed in Mainland China for about 40 years, from clinical trials to maturity. Its number has become the second in the world, its quality is also in line with the international level, and the source of donors has gradually transitioned to donation after citizen’s death (DCD). This chapter is aimed to elaborate the liver transplant work in China from the history and current status of liver transplantation, the main operating methods, major indications, donor maintenance and donor quality assessment, postoperative major complications, and application of immunosuppressive agents to the postoperative follow-up. Liver transplantation is a meaningful and challenging work currently in China; all the Chinese transplant surgeons and scholars are devoting themselves to this work in order to give more effective help to the patients.","PeriodicalId":202352,"journal":{"name":"Surgical Challenges in the Management of Liver Disease","volume":"170 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133016208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatic Regeneration Under Warm or Cold Ischemia Conditions: Controversies and New Approaches","authors":"M. E. Cornide-Petronio, M. Jiménez-Castro, E. Bujaldon, J. Gracia‐Sancho, C. Peralta","doi":"10.5772/INTECHOPEN.80340","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.80340","url":null,"abstract":"Ischemia-reperfusion (I/R) associated with hepatic resection and living related liver transplantation is an unsolved problem in clinical practice. Indeed, I/R induces damage and regenerative failure in clinical liver surgery. Signaling pathways regarding the pathophysiology of liver I/R and regeneration making clear distinction between situations of cold and warm ischemia, as well as liver regeneration with or without vascular occlusion, will be addressed. The different experimental models used to date to improve the postoperative outcomes in clinical liver surgery will be also described. Furthermore, the most updated therapeutic strategies, as well as the clinical and scientific controversies in the field, will be discussed. Such information may be useful to guide the design of better experimental models as well as the effective therapeutic strategies in liver surgery that can succeed in achieving its clinical application.","PeriodicalId":202352,"journal":{"name":"Surgical Challenges in the Management of Liver Disease","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128433548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standard Open Right Hepatectomy","authors":"L. Bredt","doi":"10.5772/INTECHOPEN.78649","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.78649","url":null,"abstract":"The evolution of hepatic resection from an imprecise removal of portions of the liver often associated with a mortality rate of up to 20% to a routine and controlled anatomic procedure with operative risk less than 5%, represents a major advance in modern surgery. This accomplishment has been made thanks to better understand-ing of the liver vascular and biliary anatomy, recognition of the functional reserve of the liver and the potential for regeneration, advances is surgical technique as well as anesthesia and perioperative care. These factors, along with the improvement of prolonged survival following hepatic resection for colorectal metastases, hepatocel-lular and cholangiocarcinoma have led to an expansion of liver surgery. In this chapter, we will give the evolution of the technique used for the standard open right hepatectomy. In addition, we will describe on detail our technique employed for right hepatectomy focusing on indications, preoperative preparation and specific technical aspects.","PeriodicalId":202352,"journal":{"name":"Surgical Challenges in the Management of Liver Disease","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131972557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}