Introduction Although gallbladder cancer is rare, accounting for just 1.2% of all global cancers, it is the most common biliary tract malignancy, making up 80% to 95% of all biliary cancer diagnoses (see Chapter 49 ). Gallbladder cancer occurs most…
Introduction Liver resection plays an increasingly important role in the management of benign as well as primary and metastatic liver tumors (see Chapters 50 , 51B , 88 , 89 , and Chapter 90, Chapter 91, Chapter 92, Chapter 93…
Introduction Major hepatectomy is typically defined as a resection of three or more contiguous hepatic segments. Most commonly, this definition encompasses right and left hemihepatectomies and extended left and right hepatectomies. Extended hemihepatectomies can include a small subsegmental portion of…
Introduction First described by Samuel Collins in 1685 and later by Abraham Vater in 1720, the ampulla of Vater is a papillary structure in the second portion of the duodenum in which the common bile duct and the pancreatic duct…
Introduction Total pancreatectomy is associated with significant metabolic consequences secondary to the loss of exocrine and endocrine function. Resultant brittle type III diabetes can be difficult to manage and result in severe recurrent hypoglycemia in some patients. Outcomes after total…
Open central (segmental) pancreatectomy is also described in detail and remains an alternative for benign, indolent, or premalignant lesions in the pancreatic neck, when an enucleation is not feasible and a lymphadenectomy not required. This technique preserves normal pancreatic tissue…
Operative approach Pancreaticoduodenectomy (PD) is one of the few remaining operations where major morbidity rates hover in the range of 25% and the 90-day mortality rate remains in the 2% to 4% range, even under the care of the highest-volume…
Introduction Hemobilia and bilhemia are clinical phenomena that arise from admixing of blood and bile due to anomalous connection between the bloodstream and biliary tract. In general terms, a fistula between the hepatic arterial supply and the bile ducts can…
Introduction A wide variety of lesions may affect the liver and pancreatic vasculature. These lesions range from common to exceedingly rare, and they can be acquired or congenital. Some are harmless, whereas others have a high risk of causing morbidity…
Introduction Injuries to the pancreas and the duodenum are some of the most feared injuries in trauma. Because of the location of the pancreatoduodenal complex (PDC) and the surrounding structures, even simple injuries are complicated and have the potential of…