Introduction Over 90% of patients presenting to a breast clinic have normal breasts or benign breast disease. Knowledge of and an understanding of the benign conditions that can affect the breast, the symptoms they cause and their management will ensure…
Patients with breast concerns that cannot be adequately managed in primary care should be referred to a specialist breast clinic. This has traditionally been run by surgeons but is now a multidisciplinary enterprise. These clinics can perform a combination of…
The breast is a defining characteristic of mammals. Its fundamental purpose is to produce milk, but the appearance and sensation provided by breasts give them a huge role in female personal and sexual identity. Surgical and other therapeutic interventions on…
Transduodenal resection of the papilla of vater Tumors arising in the region of the papilla of Vater may have their origin from the distal bile duct, the duodenum, the ampulla of Vater itself, or the pancreas. Because the epithelium of…
General principles and preoperative approaches Although pancreatic cancer is the most common of periampullary tumors, cancers of the ampulla, the duodenum, and the distal bile duct have a better long-term survival after curative pancreaticoduodenectomy. Although rare, there also are cystic…
Introduction This chapter addresses the resection of primary malignancy of the intrahepatic and extrahepatic biliary tree. Gallbladder cancer is an important extrahepatic biliary cancer that is often discovered incidentally. Cholangiocarcinoma occurs at the biliary confluence, in the mid-duct, or in…
Cholecystectomy Open cholecystectomy for cholelithiasis is performed only in cases in which laparoscopic techniques do not allow a safe procedure. Cholecystectomy is also part of other operations, such as liver resection and pancreaticoduodenectomy. Basically, two techniques are used to perform…
Introduction Most hepatic cysts, regardless of type, remain asymptomatic, and hepatic function is not affected. Occasionally cysts are the focus of hemorrhage or infection, or produce hepatic dysfunction by bile duct compression or portal hypertension. This chapter emphasizes open surgical…
Wedge resection Wedge resection of peripherally placed lesions within the liver is carried out easily for tumors measuring up to 2 to 3 cm in diameter. However, lesions occupying the convex surface of the liver and away from the free…
Introduction * * Note that resection of segments II and III (left lobectomy) in this text is described as a major resection in Chapter 5 . Segmental resection conserves functional liver parenchyma and minimizes the physiologic impact of liver resection.…