دانلود کتاب Hepato-Biliary-Pancreatic Surgery and Liver Transplantation: A Comprehensive Guide, with Video Clips

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Preface Contents List of Videos Part I: Operative Technique of Hepatectomy 1: Use of Intraoperative Ultrasonography References 2: The Techniques and Instruments for Minimizing Bleeding During Parenchymal Dissection 2.1 Methods to Control Blood Flow 2.1.1 Inflow Control, Pringle Maneuver 2.1.2 Total Vascular Exclusion 2.2 Methods and Instruments for Parenchymal Transection 2.2.1 Clamp Crushing Method 2.2.2 Cavitron Ultrasonic Surgical Aspirator (CUSA) 2.2.3 Water Jet 2.2.4 Harmonic Scalpel 2.2.5 Ligasure 2.2.6 Tissue-Link 2.2.7 Habib 2.2.8 Stapler References 3: The Safe Application of Hanging Maneuver 3.1 Liver Anatomy Based on Three Glisson’s Pedicles and Three Hepatic Veins 3.2 Hanging Maneuver 3.3 Surgical Techniques 3.4 Single Tape along the Anterior Surface of Retrohepatic IVC 3.5 Two Tapes along the Anterior Surface of Retrohepatic IVC 3.6 One Tape along the Ligamentum Venosum 3.7 One Tape along the Anterior Surface of the Retrohepatic IVC and Ligamentum Venosum 3.8 Other Types of Liver Resection by Hanging Maneuver References 4: Left Hemihepatectomy 5: Right Hemihepatectomy 5.1 Position 5.2 Laparotomy 5.3 Mobilization of Right Liver and Identification of Right Hepatic Vein 5.4 Hepatic Hilum Manipulation 5.4.1 Hepatic Hilar Vessel Manipulation 5.4.2 Manipulation of Glisson Pedicle 5.5 Liver Resection 5.6 Drainage Tube Insertion, Closure 5.7 Bleeding Control, Bile Leakage Test and Fixation of Falciform Ligament 6: Central Bisectionectomy 6.1 Preoperative Preparation 6.2 Operative Procedures [3] 6.3 Postoperative Care 6.4 Conclusion References 7: Left Lateral Sectionectomy References 8: Right Anterior Sectionectomy 8.1 Introduction 8.2 Indications and Contraindications 8.3 Preoperative Evaluation 8.4 Surgical Technique 8.4.1 Open Surgery and Laparoscopy 8.5 Complications 8.5.1 Bleeding 8.5.2 Bile Leakage 8.5.3 Oncologic Safety 8.6 Conclusion References 9: Right Posterior Sectionectomy 9.1 Indications 9.2 Technique 9.2.1 Incision 9.2.2 Cholecystectomy 9.2.3 Hepatic Hilum for Inflow Control 9.2.3.1 Individual Dissection 9.2.3.2 Glissonian Approach 9.2.4 Liver Mobilization 9.2.5 Parenchymal Division 9.2.6 Cut Surface and Drain Reference 10: S4 Segmentectomy With or Without Resection of Ventral Area of Right Anterior Section 10.1 Surgical Procedures 10.1.1 Patient Position, Incision and Peritoneal Exploration 10.1.2 Mobilization of the Liver 10.1.3 Localization of the Tumor 10.1.4 Cholecystectomy 10.1.5 Hepatectomy 10.1.5.1 Left Resection Margin 10.1.5.2 Right Resection Margin 10.1.6 Hemostasis, Drainage, and Closure 10.2 Precautions for Surgery 10.2.1 Bleeding 10.2.2 Tips for Liver Parenchymal Transection References 11: S5 & S6 Segmentectomy 11.1 Method 12: S7 & S8 Segmentectomy 12.1 Introduction 12.2 Indications and Contraindications 12.3 Preoperative Assessment and Designing the Liver Resection 12.4 Comprehending 3D Image and its Necessity in Planning the Surgery 12.5 Operative Technique 12.5.1 Laparotomy and Liver Mobilization 12.5.2 The Procedure of Anatomical Resection of Segments 7 and 8 12.5.2.1 Segmentectomy 8 12.5.2.2 Segmentectomy 7 References 13: Laparoscopic Left Hemihepatectomy 13.1 Definition 13.2 Indications 13.3 Preoperative Examination 13.4 Patient Position 13.5 Trocars Site 13.6 Pneumoperitoneum 13.7 Bleeding Control 13.8 Surgical Technique 13.8.1 Round Ligament Division 13.8.2 Cholecystectomy 13.8.3 Left Hilar Dissection and ICG (Indocyanine Green) Technique 13.8.4 Liver Mobilization 13.8.5 Liver Parenchymal Transection 13.8.6 Left Hilar Division 13.8.7 Left Hepatic Vein Division 13.8.8 Specimen Extraction 13.8.9 Check Resection Margin and Drain Tube Insertion 13.9 Summary References 14: Laparoscopic Left Lateral Sectionectomy 14.1 Indication 14.2 The Patient’s Posture and the Position of the Operators 14.3 Locations of Trocars 14.4 Steps of Surgery 14.4.1 Mobilization of the Liver (Fig. 14.2) 14.4.2 Liver Traction (Fig. 14.3) 14.4.3 Liver Resection by Glissonean Approach 14.4.4 Drain Insertion and Extraction of the Surgical Specimen 15: Laparoscopic Right Hemihepatectomy 15.1 Indication 15.2 Patient Position and Trocar Placement 15.3 Operative Technique Further Reading Part II: Deceased Donor Liver Transplantation 16: Liver Procurement in a Deceased Donor 16.1 Procedures References 17: Recipient Hepatectomy Without Venovenous Bypass 17.1 Liver Mobilization 17.2 Liver Removal 17.3 Anastomosis 18: Recipient Hepatectomy with Venovenous Bypass 18.1 Mobilization of the Recipient’s Liver 18.1.1 Patient Position and Incision 18.1.2 Division and Mobilization of the Recipient’s Liver 18.1.3 Division of the Hepatic Hilum 18.2 Installation of Veno-Venous Bypass 18.2.1 Installation Method 18.2.2 Removal Method 18.2.3 Pros and Cons of Veno-Venous Bypass 18.2.3.1 Pros 18.2.3.2 Cons 18.3 Total Hepatectomy 19: Implantation of the Deceased Donor Liver Graft 19.1 Anastomosis of IVC (Inferior Vena Cava) 19.2 Anastomosis of the Portal Vein 19.3 Reperfusion 19.4 Anastomosis of the Hepatic Artery 19.5 Bile Duct Anastomosis 19.6 Addendum Part III: Living Donor Liver Transplantation 20: Donor Right or Extended Right Hemihepatectomy 20.1 Donor Selection 20.2 Graft Selection 20.3 Incision of Operation 20.4 Liver Biopsy and Liver Mobilization 20.5 Cholecystectomy and Dissection of the Hepatic Hilum 20.6 Intraoperative Ultrasound 20.7 Hepatic Parenchymal Resection 20.8 Resection of Hepatic Duct 20.9 Hanging Maneuver 20.10 Extraction of the Graft References 21: Donor Left Hemihepatectomy 21.1 Incision and Exposure 21.2 Liver Mobilization 21.3 Placement of the Hanging Tape 21.4 Cholecystectomy 21.5 Hilar Dissection and Demarcation for Transection 21.6 Resection of the Liver Parenchyma 21.7 Resection of the Left Bile Duct 21.8 Resection of the Remaining Liver Parenchyma 21.9 Vessel Dissection and Liver Retrieval 21.10 Bench Operation 21.11 Pure Laparoscopic Donor Hepatectomy 22: Living Donor Liver Graft Back-Table Procedure 22.1 Hepatic Vein Reconstruction 22.1.1 Securing Blood Flow in the Anterior Section of the Modified Right Liver Graft 22.1.2 Middle Hepatic Vein Reconstruction of Extended Right Liver Graft 22.1.3 Reconstruction of Blood Flow in Left Liver Graft 22.1.4 Reconstruction of the Large Right Inferior Hepatic Vein 22.2 Portal Vein Reconstruction 22.2.1 Reconstruction Using the Recipient’s Portal Vein 22.2.2 Reconstruction Using Vein Graft Due to Short or Variation in the Recipient’s Portal Vein 22.3 Biliary Reconstruction 23: Middle Hepatic Vein Reconstruction of Right Liver Graft 23.1 Overview 23.2 Judgment on the Necessity of Reconstructing the Middle Hepatic Vein 23.3 Blood Vessels Used for Reconstruction 23.4 Technical Considerations for Reconstruction 23.5 Anastomosis Tips (See Video 23.1) 23.6 In the Case of Anastomosis of Right Hepatic Vein and Reconstructed Middle Hepatic Vein as a Single Orifice 23.7 Reconstructed Middle Hepatic Vein after Reperfusion References 24: Recipient Total Hepatectomy 24.1 Introduction 24.2 Surgical Method 24.2.1 Incision 24.2.2 Mobilization of the Liver 24.3 Handling of the Hepatic Hilum 24.3.1 Classical Hilar Dissection Technique 24.3.2 High Hilar Dissection Technique (HHD) 24.3.3 Modified High Hilar Dissection Technique 24.3.3.1 Whole Flow Preserving HHD 24.3.3.2 Left Flow Preserving HHD 24.4 Portal Vein Thrombectomy 24.5 Coping with and Prevention of Bleeding during Surgery 24.6 Conclusion References 25: Reconstruction of Hepatic Vein and Portal Vein 25.1 Reconstruction of Hepatic Vein 25.1.1 Back-Table Procedures 25.1.1.1 Modified Right Lobe Graft 25.1.1.2 Extended Right Lobe Graft 25.1.1.3 Left Lobe Graft 25.1.2 Recipient Operation 25.1.2.1 Modified Right Lobe Graft 25.1.2.2 Extended Right Lobe Graft 25.1.2.3 Left Lobe Graft 25.1.2.4 Dual Liver Graft Two Left-Sided Liver Grafts Right- and Left-Sided Liver Grafts 25.2 Reconstruction of Portal Vein 25.2.1 Right Lobe Graft 25.2.2 Left Lobe Graft 25.2.3 Dual Lobe Grafts References 26: Hepatic Artery Anastomosis 26.1 Introduction 26.2 Graft Artery 26.3 Recipient Artery 26.4 Anastomosis Techniques References 27: Biliary Reconstruction 27.1 Chapter Outline 27.2 Method 27.3 Conclusion References Part IV: Cholecystectomy 28: Laparoscopic Cholecystectomy (3–4 Ports Method) 28.1 Introduction 28.2 Preoperative Preparation 28.3 Anesthesia 28.4 Patient’s Posture and Arrangement of Equipment and Personnel 28.5 Surgical Techniques 28.6 Microlaparoscopic Cholecystectomy References 29: Laparoscopic Single-Site Cholecystectomy (Single Port Method) 29.1 Surgical Procedures 29.2 Conclusion References 30: Laparoscopic Surgery for Gallbladder Polyps and Early-Stage Gallbladder Cancer 30.1 Gallbladder Polyps and Early-Stage Gallbladder Cancer 30.1.1 Overview 30.1.2 Gallbladder Polyps 30.1.3 Early-Stage Gallbladder Cancer 30.2 Surgical Techniques 30.2.1 Laparoscopic Cholecystectomy 30.2.1.1 Positioning of Patients 30.2.1.2 Incision and Trocar Insertion 30.2.1.3 Surgical Sequence 30.2.2 Extended Cholecystectomy (Lymphadenectomy) 30.3 Conclusion References 31: Extended Cholecystectomy (Wedge Resection) 31.1 Surgical Procedure 31.1.1 Kocherization 31.1.2 Dissection of Cystic Duct and Execution of Frozen Biopsy of Cyst Duct Margin 31.1.3 Regional Lymphadenectomy 31.1.4 Hepatic Resection 31.2 Laparoscopic-Extended Cholecystectomy in Gallbladder Cancer References 32: Extended Cholecystectomy (Including Segment IVb and V Resection) 32.1 Operation 32.1.1 Patient’s Position and Diagnostic Laparoscopy (Fig. 32.1) 32.1.2 Incision 32.1.3 Examination of the Resection Margin of Cystic Duct 32.1.4 Kocher Maneuver and Lymph Node Dissection (Lymph Node Group #13a, 8, 12) (Fig. 32.2) 32.1.5 Liver Mobilization 32.1.6 Dissection of Glisson Pedicle (Right Glisson and Right Anterior Glisson Pedicle) for the Determination of Right Resection Line (Fig. 32.3) 32.1.7 Determination of Left and Superior Resection Lines (Fig. 32.4) 32.1.8 Management of Liver Cut Surface Further Reading Part V: Resection of Choledochal Cyst 33: Open Resection of Chledochal Cyst 33.1 Introduction 33.2 Diagnosis 33.3 Treatment Before Surgery 33.4 Treatment 33.5 Treatment of Choledochal Cysts Other Than Type I and IVb 33.6 Things to Know before Surgery 33.7 Surgical Technique 33.8 Results References Untitled 34: Laparoscopic and Robotic Excision of Choledochal Cyst 34.1 Introduction 34.2 Laparoscopic Excision of Choledochal Cyst 34.2.1 Operating Room Setup: Patient Position 34.2.2 Trocar Placement and Exposure 34.2.3 Dissection of Calot’s Triangle and Exposure of the Distal Margin of the Choledochal Cyst 34.2.4 Excision of the Choledochal Cysts 34.2.5 Roux-En-Y Reconstruction 34.2.6 Hepaticojejunostomy 34.2.7 Extracorporeal Jejunojejunostomy and Specimen Retrieval 34.2.8 Tips and Comments 34.2.9 Postoperative Management and Follow-Up of Patients 34.3 Robotic Excision of the Choledochal Cyst 34.3.1 Trocar Placement and Excision of the Choledochal Cyst via Laparoscopic Surgery 34.3.2 Robotic HJ Anastomosis 34.4 Short-Term and Long-Term Outcomes 34.5 Conclusion References Part VI: Hilar Cholangiocarcinoma 35: Extended Right Hepatectomy and Caudate Lobectomy 35.1 Indications 35.2 The Concept of Extended Right Hepatectomy 35.3 Preoperative Evaluation and Management 35.4 Intraoperative Management of Biliary Decompression Tubes 35.5 Operative Procedures Part VII: Extrahepatic Bile Duct Cancer 36: Bile Duct Resection 36.1 Introduction 36.2 Preoperative Management and Evaluation 36.3 Operative Method References 37: Pancreatico-duodenectomy 37.1 Position 37.2 Incision and Exposure 37.3 Mobilization of Pancreas Head and Duodenum 37.4 Tunneling of Pancreatic Neck 37.5 Division of Duodenum 37.6 Division of Pancreatic Neck 37.7 Division of Bile Duct and Regional Lymphadenectomy 37.8 Division of Jejunum 37.9 Dissection of Uncinate Process, Retroperitoneal Tissues, and Nerve Plexus 37.9.1 Dissection of Uncinate Process 37.9.2 Retroperitoneal Tissues 37.9.3 Dissection of Lymph Nodes and Nerve Plexus around SMA 37.10 Reconstruction 37.10.1 Pancreaticojejunostomy 37.10.2 Hepaticojejunostomy 37.10.3 Duodenojejunostomy 37.11 Insertion of Drain and Closure 38: Hepatopancreatoduodenectomy 38.1 Indications and Contraindications 38.2 Preoperative Evaluation and Design for Surgical Resection 38.3 Surgical Techniques 38.4 Risks and Pitfalls During Surgery 38.5 Conclusion References Part VIII: Operative Technique of Pancreatectomy 39: Pylorus-Preserving Pancreaticoduodenectomy 39.1 Surgical Techniques 39.1.1 Patient Position and Skin Incision 39.1.2 Kocher Maneuver 39.1.3 Pancreatic Approach 39.1.4 Duodenal Surgery 39.1.5 Dissection of Lesser Sac 39.1.6 Division of the Pancreas 39.1.7 Mobilization of the Ligament of Treitz and SMA Dissection 39.1.8 Reconstruction and Pancreaticojejunostomy 39.1.9 Hepaticojejunostomy and Duodenostomy References 40: Radical Antegrade Modular Pancreatosplenectomy (RAMPS) 40.1 The Procedure 40.1.1 Skin Incision 40.1.2 Expose of Pancreas 40.1.3 Kocherization 40.1.4 Dividing Neck of the Pancreas 40.1.5 Ligation of Splenic Vessels and Dissection of Lymph Node 40.1.6 Determination of Posterior Plane of Dissection 40.1.7 Combined Resection of Other Organs Reference Further Reading 41: Spleen-Preserving Distal Pancreatectomy 41.1 Introduction 41.1.1 Terminology 41.1.2 Definition 41.1.3 Indications 41.2 Surgical Technique 41.2.1 Incision 41.2.2 Exposure of Pancreas and Confirmation of Pancreatic Tumor Location 41.2.3 Pancreatic Dissection 41.2.4 Management of the Pancreatic Remnant 41.2.5 Pancreatic Detachment from the Splenic Vein 41.3 The Surgical Field of View Is Evaluated before Completing the Surgery and Post-Operative Patient Care References 42: Laparoscopic Pancreaticoduodenectomy 42.1 Historical Background 42.2 Surgical Management References 43: Laparoscopic Distal Pancreatectomy 43.1 Introduction 43.2 Indications 43.3 Preoperative Factors 43.3.1 Patient Assessment 43.3.2 Tumor Assessment 43.3.3 Planning Operation 43.4 Operative Technique 43.4.1 Patient Posture 43.4.2 Trocar Placement 43.4.3 Access to Pancreas 43.4.4 Pancreatic Division 43.4.4.1 Endo-GIA Stapler 43.4.4.2 Ultrasonic Sheers 43.4.5 Vascular Control 43.4.5.1 Splenic Artery 43.4.5.2 Splenic Vein 43.4.5.3 Small Tributary Vessels 43.4.6 Surgical Design 43.4.6.1 50% > Distal Pancreatectomy: Modified Lasso Technique 43.4.6.2 70% Distal Pancreatectomy: “Subtotal (Extended)” Distal Pancreatosplenectomy 43.4.6.3 50% Distal Pancreatectomy 43.4.7 Spleen-Preserving Procedure 43.5 Methods to Prevent POPF after Distal Pancreatectomy 43.6 Intraoperative Peritoneal Drainage 43.7 Special Consideration 43.7.1 The Role of Spleen in Adult Patients 43.7.2 Application in Left-Sided Pancreatic Cancer 43.7.3 Role of Robotic Surgical System in Laparoscopic Distal Pancreatectomy 43.7.4 Robotic Single-Site plus ONE-Port Distal Pancreatectomy References Video Articles 44: Laparoscopic Central Pancreatectomy 44.1 Operative Procedure 44.1.1 Patient Position and Trocar Placement 44.1.2 Approach to the Pancreas 44.1.3 Dissection of the Pancreas and Exposure of the Superior Mesenteric Vein (SMV) and the Portal Vein (PV) 44.1.4 Proximal and Distal Pancreatic Division 44.1.5 Pancreatic Anastomosis 44.1.6 Drain Placement 45: Transduodenal Ampullectomy of Ampullary Adenoma 45.1 Introduction 45.2 Indications and Contraindications 45.3 Preoperative Evaluation 45.4 Surgical Procedures 45.4.1 Incision 45.4.2 Kocher Maneuver 45.4.3 Incision of the Duodenum 45.4.4 Excision of the AoV 45.4.5 Ductoplasty of the Bile and Pancreatic Ducts 45.4.6 Implantation of Common Duct into Duodenum 45.4.7 Closure of Duodenostomy 45.4.8 Drain Insertion and Abdominal Wall Closure 45.5 Conclusion References 46: Essential Tips for Pancreatic and Duodenal Surgery: Vessel Resection 46.1 Combined Venous Resection 46.1.1 End-to-End Anastomosis 46.1.2 Interposition Grafting 46.1.2.1 Autogenous Vessels 46.1.2.2 Cadaveric Vessels 46.1.2.3 Xenogenic Graft, Bovine Pericardial Patch 46.1.2.4 Artificial Graft: Polytetrafluoroethylene (PTFE, Gore-Tex®) Grafts 46.2 Combined Arterial Resection 46.2.1 Proper Hepatic/Right Hepatic Arterial Resection 46.2.2 Distal Pancreatectomy with Celiac Axis Resection (DP-CAR, Appleby Operation) 46.2.3 Resection of Superior Mesenteric Artery References 47: Essential Tips for Reconstruction After Pancreaticoduodenectomy 47.1 Pancreaticojejunostomy 47.1.1 Modified Blumgart Duct-to-Mucosa Technique 47.1.2 Conventional 2-Layer Duct-to-Mucosa Technique 47.2 External Drainage of Pancreatic Duct 47.2.1 Transjejunal External Drainage of Pancreatic Duct 47.2.1.1 Background 47.2.1.2 Surgical Technique 47.2.1.3 Post-Surgery Management 47.2.2 Transhepatic External Drainage of Pancreatic Duct 47.3 Pancreaticogastrostomy 47.3.1 Preparation of Pancreas 47.3.2 Preparation of Stomach 47.3.3 Pancreatic-Gastric Anastomosis 47.3.4 Pros and Cons of Pancreaticogastrostomy References