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肝脏外科:要点和盲点(第2版)(翻译版)

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肝脏外科:要点和盲点(第2版)(翻译版)

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将那些奋斗在第一线的外科专家的宝贵经验和智慧与严谨的科学相结合,并使之成为一种“艺术”而得到广泛传播!
·传授日常诊疗常规中的一些需特别注意、操作性强的“要点”及容易失误、值得借鉴的“盲点”,即临床工作的“秘诀”。
·不仅有手术技巧的详解,还包括影像诊断、介入操作和围手术期管理的相关知识,全面满足临床的需要。
·分专题加以阐述,与之相关的小知识或方法以“一点建议”、“咖啡时间”等形式“点缀”其中。
·文字简洁易懂,配以真实清晰的术中照片和精美的彩色插图。
·从年轻医生到资深专家,都可根据自己的兴趣和水平选择相应的章节以汲取“营养”。
Content Description

在《肝脏外科:要点和盲点(第2版)(翻译版)》内容的选择上,作者依照临床的诊疗流程选择了对实际工作有指导意义的项目,不仅介绍了手术方法,而且有影像诊断、介入操作和围手术期管理的相关知识。在内容的编排上,各方面的内容分为专题加以阐述,与之相关的小知识或方法以“一点建议”、“咖啡时间”的形式穿插其中。从年轻医生到资深专家的各层次读者都可以根据自己的兴趣和水平从中得到自己想要的信息。对于初学者,《肝脏外科:要点和盲点(第2版)(翻译版)》可作为进入手术室前翻阅的书刊;对于专家,《肝脏外科:要点和盲点(第2版)(翻译版)》可以帮助回顾和总结一下自己的操作方法。
由前东京大学幕内雅敏教授主编的“要点与盲点”丛书自出版以来好评如潮,在日本的外科医生中几乎人手一册,在日留学的外科医生也有爱不释手之感。受二村雄次教授所托,我们有幸将其翻译介绍给国内同行。
该丛书中的“要点与盲点:肝脏外科”由前东京大学教授、东京红十字医疗中心院长幕内雅敏主编,反映了当代肝脏外科的最高水平。《肝脏外科:要点和盲点(第2版)(翻译版)》主要介绍了东京大学第二外科的基本理念和做法,即所谓的“东大流派”。幕内雅敏教授是世界上第一个将术中超声成功用于肝胆外科临床实践的学者,首次提出了解剖性肝段(亚区域)切除的方法并创立了很多新的术式。同时,在活体肝移植方面也有着世界一流的成绩。
Author Description

幕内雅敏教授(Prof.Masatoshi Makuuchi)1946年生于东京,1973年毕业于东京大学医学部,1979年任东京国立癌中心医长,1989年任信州大学第一外科教授,1994年回到东京大学任第二外科教授,2007年转任东京红十字病院院长。
幕内教授是国际肝脏外科和肝脏移植领域最负盛名的专家之一,被誉为“肝脏外科的王者”。他对肝胆外科无比热爱,一直潜心学术研究,努力挑战外科极限,取得了一系列举世公认的创新性成就:肝胆外科的术中超声、解剖性肝段切除、保留肝右下静脉的右肝部分切除术、极量肝切除前的选择性门静脉栓塞术及首例成人间的活体肝移植等等。他所领导的东京大学第二外科一直走在世界肝脏外科的最前沿。
幕内教授现任IASGO(国际外科、消化科、肿瘤科医师协会)主席,是欧洲医学会等多个学会的名誉会员,并曾担任日本外科学会会长,是《Lancet》、《Hepatology》等多个杂志的编委或审稿人。目前为止,发表英文论文850余篇,主编英文专著7部,参予编写英文专著66部。
幕内教授对中国医学同行十分友好,多次应邀来华讲学和手术演示,热心传播最新的肝脏外科理论与技术,他所在的东京大学第二外科接受了一大批中国留学生和研修生。他对中国肝脏外科和肝脏移植事业给予了巨大的帮助,赢得了中国同行的尊敬和爱戴。
译者简介:
董家鸿教授,(Prof Dong Jiahong)1960年生于江苏省连云港市,师从著名肝胆外科学家黄志强院士,获得医学硕士和博士学位。曾作为访问学者或客座研究员先后访问过巴黎大学Paul Brollsse肝胆中心、匹兹堡大学移植研究所、加州大学洛杉矶分校外科、名古屋大学肿瘤外科、京都大学肝移植外科、香港大学玛丽医院肝胆胰外科等国际著名肝胆外科和肝移植中心,博采众家之长,形成了自己的学术流派。1998年任西南医院全军肝胆外科中心主任及全军肝胆外科研究所所长,2006年起历任解放军总医院肝胆外科主任、肝胆外科医院院长。
董家鸿教授是中国肝胆外科和肝脏移植领域年轻一代的领军人物,在肝脏移植及肝胆胰肿瘤、胆管结石及狭窄、肝硬化门静脉高压症、急性和慢性肝功能衰竭的外科治疗领域卓有建树。1996年开展了国内首例离体肝切除,2002年在国际上首创了针对复杂肝胆管结石的只保留尾状叶的肝脏次全切除术。
董家鸿教授现任美国外科学院院士、国际消化外科学会执行委员、中华外科学会常委、中华器官移植学会常委、中华外科学会胆道学组组长。担任《中华消化外科杂志》总编辑,同时担任30余种核心期刊的主编或编委。任山东大学、南开大学、厦门大学、昆明医学院和徐州医学院等多所大学的特聘教授或荣誉教授。曾获国家科技进步一等奖等多项奖励,多次代表中国肝胆外科界在国际学术会议上做特邀专题演讲。
Catalogue

Ⅰ 肝脏删把握的要点与盲点
1.肝脏的分区及其染色
2.肝区域的外科划分
3.Glisson系统的脉管解剖
4.静脉系统的解剖
5.应该知道的解剖变异

Ⅱ 肝脏月中瘤诊断的要点与盲点
1.临床检查和肿瘤标记物
2.影像诊断的程序
3.以手术为前提的综合影像诊断
4.影像学鉴别诊断的要点
5.当肿瘤性质难以诊断时
6.脉管内肿瘤进展的诊断
7.新的影像学诊断技术
8.外科医生应掌握的肝脏肿瘤病理知识

Ⅲ 判断肝脏手适应证的要点与盲点
1.肝细胞癌
2.胆管细胞癌
3.转移性肝癌
4.良性肝肿瘤

Ⅳ 肝脏术前管理的要点一与盲点
1.必须检查一览
2.必须处置一览
3.营养管理一览
4.肝硬化患者的术前管理
5.有高危因素的患者
6.用cT计算肝脏体积
7.门静脉栓塞术的适应证
8.术前的临床路径

Ⅴ 肝切除一般手术技术的要点与盲点
1.肝切除的必需工具
2.肝切除的麻醉和管理
3.常用的开腹、开胸法
4.根据术中超声理解解剖结构
5.肿瘤的术中超声诊断
6.术中活检的意义
7.术中的胆道引流法
8.肝门部分别处理的操作技术
9.肝门部一并处理的操作技术
10.处理肝静脉的操作技术
11.染色法确定肝脏分区
12.各种肝脏血流阻断技术及选择
13.用Pean钳子进行肝离断
14.利用CUSA进行肝离断
15.用超声刀进行肝离断
16.用漂浮球进行肝离断
17.用结扎器械行肝离断
18.在肝离断中左手的作用
19.什么是优秀的一助
20.在离断面显露出肝静脉的要点
21.肝离断术中的难题
22.处理肝脏断面的实际操作
23.关腹和引流的常识

Ⅵ 肝切除特殊手术技术的要点与盲点
1.门静脉重建的方法
2.肝动脉重建的方法
3.肝静脉重建的方法
4.胆道重建的方法
5.下腔静脉重建的方法
6.门静脉栓塞术的操作技术
7.全肝血流阻断下肝切除术的适应证及操作技术
8.体外循环下肝切除的适应证和技术
9.腹腔镜下肝切除的适应证和技术

Ⅶ 各栅脏切除术的要点与盲点
1.肝切除的命名法
2.右半肝切除术(S5~S8切除术)
3.右三叶切除术(S4~S8切除术)
4.左半肝切除术(S2~s4切除术)
5.左三叶切除术(S2~S4+S5,S8切除术)
6.半肝胰十二指肠切除
7.中肝叶切除术(S4+S5+S8切除术)
8.右前叶切除术(S5+S8切除术)
9.右后叶切除术(S6+S7切除术)
10.左外叶切除术(S2+S3切除术)
11.S3,4切除术
12.保留肝右下静脉的手术
13.S8切除与S7切除术
14.S5切除与S6切除术
15.s4切除术
16.锥形肝区域(区划)切除术
17.右S1切除术
18.左S1切除术
19.前方入路的S1切除术
20.背侧入路的S1全切术
21.不规则的肝局部切除术

Ⅷ 肝脏术后管理的要点与盲点
1.必需的检查及其解读
2.输液方案的制定
3.肝硬化患者的术后处理
4.引流管理的基本要点
5.标本整理和规约记载的方法
6.术后随访的要点
7.术后的临床路径
8.预防感染的基本方法

Ⅸ 肝脏术后并发症处理的要点与盲点
1.术后出血的体征和再开腹的判断
……
Ⅹ 活体肝移植的要点与盲点
索引
一点建议
●活检诊断的关键59
●早期肝癌和癌前病变60
●肝癌的多中心发生61
●复发的肝细胞癌适宜切除吗66
●Child分级和肝功能不全分级68
●门静脉癌栓的手术方针70
●胆管细胞癌和淋巴结廓清75
●胃癌肝转移适合切除吗80
●对于胆管癌栓的术中胆道引流128
●肝脏的游离及其范围133
●肾上腺静脉的处理方法139
●Amntius管144
●安全显露下腔静脉的方法149
●利用超声引导离断的方向162
●肝离断法的比较167
●作为附加手术的Hassab术188
●处理右膈下动脉的方法190
●预定重建脉管的切断时机199
●体外肝切除及生物泵是必要的吗231
●扩大右三叶切除术256
●扩大左三叶切除术257
●外生型肝癌切除的要点263
●何谓肝右下静脉283
●尾状叶的立体构造306
●关于活体肝移植术的背景365
●肝移植手术的变迁373
●冷冻静脉的保存387
……
Book Abstract

在直径为2~3cm的HCC的早期病例中,实验室检查反映的是背景肝的肝硬化或慢性肝炎的病变。随着肿瘤的增大,背景肝病变加重,血清胆红素浓度、ALP值、LDH值会有所增加。肿瘤进展伴有脉管浸润、腹水潴留、胆管侵犯时,也会有胆道系的酶的上升和梗阻性黄疸,与肝功能不全导致的腹水、黄疸的鉴别有一定困难。另外,HCC在其进展过程中可能会有低血糖发作、高胆固醇血症等副癌综合征(paraneoplastic syndrome)出现,此外还可能会有高钙血症和红细胞、血小板数的增加。
2.肿瘤标记物
作为特异的肿瘤标记物,AFP和PIVKA-Ⅱ很有价值,但它们对早期诊断的意义不大。如果AFP值超过400ng/ml,可考虑为肝癌;在100~200ng/ml时,与由“肝炎”引起的AFP升高相鉴别就很重要。图1显示的是将作者所在科室的HCC按原发性肝癌处理规约进行分期后,各期的AFP值与肝硬化病例的AFP值所作的比较。在I期中,AFP值的阳性率分别为53.7%(>20ng/m1)和19.5%(>200ng/m1);而肝硬化组中相应的阳性率分别为37.1%和5.7%,两者AFP分布类似,不能说其对早期诊断有较高的价值。为了鉴别肝癌由来的AFP和肝炎由来的AFP,可利用植物凝集素结合试验来显示两者糖链结构的差异,研究结果如图2所示。AFP值在50n~ml以上的肝癌和肝硬化病例中,LCA的L3亚型及PHA.E的P4亚型中的任何一个超过正常值(20%)者定为肝细胞癌型;两者都在正常值以下则认为是肝硬化型。50例肝癌患者中有27例(54%)为肝细胞癌型,36例肝硬化中只有2例是肝细胞癌型,所以通过凝集素亲和性分析能提高AFP对于肝癌的特异性。在日本,AFP.L3亚型检查现已纳入医疗保险。
Introduction

由前东京大学幕内雅敏教授主编的“要点与盲点”丛书自出版以来好评如潮,在日本的外科医生中几乎人手一册,在日留学的外科医生也有爱不释手之感。受二村雄次教授所托,我们有幸将其翻译介绍给国内同行。
该丛书中的“要点与盲点:肝脏外科”由前东京大学教授、东京红十字医疗中心院长幕内雅敏主编,反映了当代肝脏外科的最高水平。本书主要介绍了东京大学第二外科的基本理念和做法,即所谓的“东大流派”。幕内雅敏教授是世界上第一个将术中超声成功用于肝胆外科临床实践的学者,首次提出了解剖性肝段(亚区域)切除的方法并创立了很多新的术式。同时,在活体肝移植方面也有着世界一流的成绩。
在本书内容的选择上,作者依照临床的诊疗流程选择了对实际工作有指导意义的项目,不仅介绍了手术方法,而且有影像诊断、介入操作和围手术期管理的相关知识。在内容的编排上,各方面的内容分为专题加以阐述,与之相关的小知识或方法以“一点建议”、“咖啡时间”的形式穿插其中。从年轻医生到资深专家的各层次读者都可以根据自己的兴趣和水平从中得到自己想要的信息。对于初学者,本书可作为进入手术室前翻阅的书刊;对于专家,本书可以帮助回顾和总结一下自己的操作方法。
书中没有大段的理论阐述,主要介绍了在肝脏外科日常诊疗常规中的一些特别要注意的、可操作性强的“要点”及容易失误的“盲点”,即所谓的临床工作的“秘诀”。而且,全书多用彩色印刷,配以真实清晰的术中照片和精美的彩色插图,在视觉上给人以美好的享受。
熟读本书,可领略到肝脏外科诊断和治疗各个领域的精华所在,更可欣赏到日本学者多年来不懈努力和实践所创造的外科艺术体系。诚如二村雄次教授所言,肿瘤外科医生要有“斗魂”,为了病人的健康孜孜以求和精益求精,通过各种手段对病人进行精确诊断和精准手术。
由于肝胆胰外科的用词在世界范围内尚未统一,同时中日两国的医疗制度也存在差异,故本丛书尽量按照国内医生的用语习惯进行翻译,个别无法统一的地方以“译者注”的形式在文中标出。
感谢国内外的专家们的通力合作,使得本书的翻译能够顺利完成。但由于本书的内容博大精深,涉及临床的方方面面。译者们虽尽力而为,疏漏之处在所难免,恳请斧正。

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Yami Gift Card

Get this exclusive deal when paying with gift card

Terms and Conditions

Gift card deals are special offers for selected products;

The gift card deals will automatically be activated if a customer uses gift card balance at check out and the balance is sufficient to pay for the total price of the shopping cart products with gift card deals;

You will not be able to activate the gift card deals if you choose other payment methods besides gift card. The products will be purchased at their normal prices;

If your account balance is not enough to pay for the products with gift card deals, you can choose to reload your gift card balance by clicking on the Reload button at either shopping cart page or check out page;

Products that have gift card deals can be recognized by a special symbol showing 'GC Deal';

For any additional questions or concerns, please contact our customer service;

Yamibuy reserves the right of final interpretation.

Sold by Yami

Service Guarantee

Yami Free Shipping over $49
Yami Easy Returns
Yami Ships from United States

Shipping

  • United States

    Standard Shipping is $5.99 (Excluding Alaska & Hawaii). Free on orders of $49 or more.

    Local Express is $5.99 (Available in Parts of CA, NJ, MA & PA). Free on orders of $49 or more.

    2-Day Express (Includes Alaska & Hawaii) starts at $19.99.

Return Policy

Yami is committed to provide our customers with a peace of mind when purchasing from us. Most items shipped from Yamibuy.com can be returned within 30 days of receipt of shipment (For Food, Beverages, Snacks, Dry Goods, Health supplements, Fresh Grocery and Perishables Goods, within 7 days of receipt of shipment due to damages or quality issues; To ensure that every customer receives safe and high-quality products, we do not provide refunds or returns for beauty products once they have been opened or used, except in the case of quality issues; Some products may have different policies or requirements associated with them, please see below for products under special categories, or contact Yami Customer Service for further assistance).
Thank you for your understanding and support.

Learn More

Sold by Yami

Terms and Conditions of Yami E-Gift Card

If you choose “Redeem automatically” as your delivery method, your gift card balance will be reload automatically after your order has been processed successfully;

If you choose “Send to Email”as your delivery method, the card number and CVV will be sent to the email address automatically;

Any user can use the card number and CVV to redeem the gift card, please keep your gift card information safely. If you have any trouble receiving email, please contact Yami customer service;

Yami gift card can be used to purchase both Yami owned or Marketplace products;

Yami gift card will never expire;

Yami gift card balance does not have to be used up at once;

All rights reserved by Yami.

Return Policy

Gift card that has already been consumed is non-refundable.

Sold by JD@CHINA

Service Guarantee

Yami Free Shipping over $49
Yami Easy Returns
Yami Ships from United States

Shipping

  • United States

    Standard Shipping is $5.99 (Excluding Alaska & Hawaii). Free on orders of $49 or more.

    Local Express is $5.99 (Available in Parts of CA, NJ, MA & PA). Free on orders of $49 or more.

    2-Day Express (Includes Alaska & Hawaii) starts at $19.99.

Return Policy

You may return product within 30 days upon receiving the product. Items returned must be new in it's original packing, including the original invoice for the purchase. Customer return product at their own expense.

Sold by JD@CHINA

Service Guarantee

Yami Cross-store Free Shipping over $69
Yami 30-days Return

Yami-China FC

Yami has a consolidation warehouse in China which collects multiple sellers’ packages and combines to one order. Our Yami consolidation warehouse will directly ship the packages to your door. Cross-store free shipping over $69.

Return Policy

You may return products within 30 days upon receiving the products. Sellers take responsibilities for any wrong shipment or missing items. Packing needs to be unopened for any other than quality issues return. We promise to pack carefully, but because goods are taking long journey to destinations, simple damages to packaging may occur. Any damages not causing internal goods quality problems are not allowed to return. If you open the package and any quality problem is found, please contact customer service within three days after receipt of goods.

Shipping Information

Yami Consolidation Service Shipping Fee $9.99(Free shipping over $69)

Sellers in China will ship their orders within 1-2 business days once the order is placed. Packages are sent to our consolidation warehouse in China and combined there. Our Yami consolidation warehouse will directly ship the packages to you via UPS. The average time for UPS to ship from China to the United States is about 10 working days and it can be traced using the tracking number. Due to the pandemic, the delivery time may be delayed by about 5 days. The package needs to be signed by the guest. If the receipt is not signed, the customer shall bear the risk of loss of the package.

Sold by JD@CHINA

Service Guarantee

Free shipping over 69
Genuine guarantee

Shipping

Yami Consolidated Shipping $9.99(Free shipping over $69)


Seller will ship the orders within 1-2 business days. The logistics time limit is expected to be 7-15 working days. In case of customs clearance, the delivery time will be extended by 3-7 days. The final receipt date is subject to the information of the postal company.

Yami Points information

All items are excluding from any promotion or points events on Yamibuy.com

Return Policy

You may return product within 30 days upon receiving the product. Items returned must be new in it's original packing, including the original invoice for the purchase. Customer return product at their own expense.

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Jingdong book

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Jingdong book