|Operative Solutions in Hepatobiliary and Pancreatic Surgery|
|Thursday, 02 September 2010|
Operative Solutions in Hepatobiliary and Pancreatic Surgery, Dennison AR, Maddern GJ, Oxford University Press, 2010, ISBN: 978-0199584178, RRP £69.95
This book is highly compact with a concise overview of common and complex hepatobiliary pancreatic surgery (HPB). The book is organised into five chapters, one each for the pancreas, duodenum, liver, gallbladder and biliary tract. Although the book’s title emphasises operative solutions, each chapter begins with a summary of individual diseases such as pancreatitis, including relevant anatomy and clinicopathological aspects, which are well referenced. However, the operative procedures and the postoperative management aspects have mostly been written without quoting references, mainly guided by the personal experience of two HPB surgeons. Throughout, there are a plethora of flow charts and line diagrams to improve the understanding of the care pathway of HPB problems, perioperative care and the management of complications.
There are useful tips such as ‘lying prone on the tummy after cystogastrostomy to help emptying the cystic content’ and ‘We do not consent people to lap cholecystectomy but instead to have the gallbladder removed, probably by key-hole surgery’. There is good advice on upper gastrointestinal bleeding management, post ERCP bleeding, and ‘stuck basket at ERCP’.
‘Hilar structure compared to left hand’ will help surgical trainees understand the anatomy of this complex region and there is a good account on ‘access limb’ as an allude to complex biliary stricture surgery.
There are also controversial aspects to this book. The authors do not believe in caudate resection for Klastskin tumours. ‘T Tubes ought not to be clamped for any reason’ is bound to raise disagreement. I disagree with the authors’ suggestion that T-tubes could be removed within two weeks, as this could lead to an intraperitoneal leak since they are made of less reactive materials which often result in flimsy tracts prone to disruption.
I was surprised to see the omission of the ‘Imrie’ Criteria for acute pancreatitis and also the inclusion of a ‘moderate’ category for acute pancreatitis. There is no mention of pancreatogastrostomy, Beger’s or Frey’s procedures.
On balance, it is full of useful tips arising from the authors’ personal experience and liver surgery is the highlight of the book! I recommend this book to upper GI/HPB trainees and to young consultants with a specialist interest.