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Blumgart's Surgery of the Liver, Billary Tract, and Pancreas, 5th Edition  Two-Volume Set
Editors: Jarnagin, Belghiti, Buchler, Chapman, D'Angelica, DeMatteo, and Hann
ISBN 13:
Elsevier/ Saunders  2012
List Price: $495.00   2008 Pages  Hard Cover  Two-Volume Set with Expert Consult Searchable Text and Video Content
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   MedicalScienceBooks.com Medical Book Review:

     The vital organs housed in the abdominal cavity are a major source of morbidity and mortality even if we do not consider the many carcinomas which arise and spread to this region.  Fortunately, this is also one of the most surgically approachable areas of the body given the proximity of the underlying organs to the abdominal wall.   This is not to understate the complexity and delicate nature of the many miles of blood vessels and nerves which supply these regions.  Indeed, the surgeon who is to perform any procedure dealing with the liver and its related structures must work with careful tact in order to avoid causing more damage to the patient than the disease process which requires an operation.  Blumgartís Surgery of the Liver, Biliary Tract, and Pancreas is one of the few resources which surgeons can turn to for the comprehensive coverage of the surgical anatomy and advancements in technique which are paramount to successful patient management.

     Blumgartís is organized around the theme of breaking down the material into parts based on organ and then further divides parts into sections that cover various etiologies of disease.  For example, the part on hepatic disease includes sections on inflammatory, infective and congenital disease as well as neoplastic and treatment resections.  There is also excellent coverage of the basic anatomy of the liver, gallbladder and pancreas with special attention given to the most common anatomic variations that can be encountered in the operating room.  Although most of the illustrations in this text are in black & white, they still convey the most essential information that the authors intend.  They are also supplemented by ample numbers of ultrasound and other images which demonstrate the utility of careful planning for operations which arenít of an emergent nature.  Unlike many other surgical texts on this or other topics, Blumgartís also does an admirable job in teaching the physiology of the organs it covers and explain its basic nonsurgical diagnostic work-up.  Although of less concern for the surgeon than for the primary care physician, this information becomes increasingly important when making decisions about resectioning portions of the liver, for example.  A better grasp of the functioning of the liver together with more detailed anatomical consideration will lead to better surgical outcomes by maximizing viable tissue which can take over functioning in the patient.

     The scores of contributors to this edition have each added an important and unique perspective to the existing literature on surgery in the upper abdomen.  Recent research is expertly summarized and there is no hesitation on the part of the authors to call something controversial.  For many surgeries dealing with the pancreas and liver, there are a variety of approaches which can be taken that will provide comparable positive results in terms of patient symptoms and disease regression.  There will be differences between institutions as to the approach they feel is best to take.  Many of these areas of personal decision are discussed at some length in this text including issues such as laparoscopic versus other modalities when operating on gallstones in the common bile duct. 

     Blumgartís Surgery of the Liver, Biliary Tract, and Pancreas 5th edition is a solid text which will form the foundation for many up and coming general and specialist surgeons who will deal with a wide range of surgical presentations in the abdomen.  For those established surgeons, many of whom already have a well-worn older edition of Blumgartís will find this edition to be an even greater asset in assessing the  growing literature in this area.


Ratings (1-10 , 10 being the highest):

Overall Rating:


Authorís objectives met:



Organization of information: 9
Significant number of illustrations: 9
Suitable for intended audience: 10
Overall presentation: 10
Quality of illustrations: 8
Usefulness of book:   10
Value: 9
Writing style: 9


Comprehensive and complete, Blumgart's Surgery of the Liver, Pancreas and Biliary Tract - edited by Dr. William R. Jarnagin and a team of experts- delivers the comprehensive, cutting-edge guidance you need to achieve optimal outcomes in surgery of the liver, biliary tract, and pancreas. Edited by a panel of experts and featuring contributions by many leading authorities, this 2-volume reference brings you the latest information on pathology, diagnostics, surgery, and non-operative intervention all in one source. At www.expertconsult.com you can not only access the complete contents online, but also an abundance of detailed illustrations and step-by-step procedural video clips from the Memorial Sloan Kettering video library that show you how to perform key procedures step by step.

New to this edition:

    • See how to perform key procedures by watching operative videos from the Memorial Sloan Kettering video library.
    • Apply the most advanced diagnostic and management options for each disease, including interventional techniques.
    • Stay current with the latest knowledge and advancements including minimally invasive techniques in hepatic resection; surgical considerations for congenital disorders of the pancreas; non-surgical therapies for pancreatic cancer; microwave ablation and other emerging technologies; the most recent developments in the rapidly changing area of transplantation; and the newest best practices in pre- and post-operative care and blood transfusion.
    • Get in-depth coverage of the pancreas from the only fully comprehensive text on both hepatobiliary and pancreatic surgery.
    • Learn from the very best. Rely on the trusted guidance of experts, with a fresh perspective from senior editor, Dr. William Jarnigan, who has earned a national and international reputation in the surgical management of diseases of the biliary tract.
    • Access the full text online at www.expertconsult.com, along with image and video libraries, tables, figures, and more!

Key Features:

    • Glean all essential, up-to-date, need-to-know information in one comprehensive reference that provides extensive coverage of pathology, diagnostics, surgery, and non-operative intervention as well as hepatobiliary and pancreatic surgery.
    • Deepen your understanding of surgical anatomy to help with diagnosis, surgical operation, interventional radiology, and endoscopy.

Table of Contents:

Volume I

Introduction: Hepatobiliary and Pancreatic Surgery: Historical Perspective

Part 1: Liver, Biliary, and Pancreatic Anatomy and Physiology

1A  Embryologic Development of the LIver, Biliary Tract, and Pancreas
1B  Surgical and Radiologic Anatomy of the Liver, Biliary Tract, and Pancreas
2. Assessment of Hepatic Function: Implications for the Surgical Patient
3. Pancreatic Physiology and Functional Assessment
4. Liver Blood Flow: Physiology, Measurement, and Clinical Relevance
5. Liver Regeneration: Mechanisms and Clinical Relevance
6. Liver Fibrogenesis: Mechanisms and Clinical Relevance
7. Bile Secretion and Pathophysiology of Biliary Tract Obstruction
8A  Pancreatic Cancer and Premalignant Tumors: Molecular Aspects
8B  Molecular Pathogenesis of Biliary Tract Cancer
8C  Molecular Biology of Liver Cardiogenesis and Hepatitis
9. Liver Immunology
10. Cytokines in Liver, Biliary, and Pancreatic Disease
11. Infections in Liver, Biliary, and Pancreatic Surgery

Part 2: Diagnostic Techniques

12. Clinical Investigation of Hepatopancreaticobiliary Disease
13. Ultrasound of the Liver, Biliary Tract, and Pancreas
14. Endoscopic Ultrasound of the Biliary Tract and Pancreas
15. Nuclear Medicine Techniques in Hepatobiliary and Pancreatic Disease
16. Computed Tomography of the lIver, Biliary Tract, and Pancreas
17. Magnetic Resonance Imaging of the Liver, Biliary Tract, and Pancreas
18. Direct Cholangiography: Approaches, Techniques, and Current Role
19. Diagnostic Angiography in Hepatobiliary and Pancreatic Disease: Indications
20. Percutaneous Biopsy
21. Intraoperative Diagnostic Techniques

Part 3: Anesthetic Management, Preoperative and Postoperative Care

22. Intraoperative and Immediate Postoperative Management
23. Perioperative Critical Care in Hepatopancreatobiliary Patients
24. Preoperative and Postoperative Nutrition in Hepatobiliary Surgery
25. Postoperative Complications Requiring Intervention, Diagnosis, and Management
26. Quality of Life and hepatopancreatobiliary Tumors

Part 4: Techniques of Biliary Tract INtervention: Radiologic, Endoscopic, and Surgical

27. Interventional Endoscopy: Technical Aspects
28. Radiologic Hepatobiliary Interventions
29. Bile Duct Exploration and Biliary-Enteric Anastomosis

Part 5: Biliary Tract Disease

Section 1.  Inflammatory, Infective, and Congenital
Subsection A. Gallstones and Gallbladder

30. Natural History of Gallstones and Asymptomatic Gallstones
31. Cholecystitis
32. Percutaneous Approaches to the Treatment of Gallbladder Disease
33. Technique of Cholecystectomy
34. Laparoscopic Cholecystectomy and Choledocholithotomy
35. Stones in the Bile Duct: Clinical Features and Open Surgical Approaches and Techniques
36. Stones in the Bile Duct: Endoscopic and Percutaneous Approaches
37. Cholecystolithiasis and Stones in the Common Bile Duct: Which Approach and When?
38. Postcholecystectomy Problems
39. Intrahepatic Stones

Subseciton B. Biliary Stricture and Fistula

40. Biliary Atresia
41. Primary Sclerosing Cholangitis
42 A. Benign Biliary Strictures
42 B. Biliary Fistulae

Section C.  Biliary INfection adn INfestation

43. Cholangitis
44. Recurrent Pyogenic Cholangitis
45. Biliary Parasitic Disease

Subsection D. cystic Disease of the Biliary Tree

46. Bile Duct Cysts in Adults

Section II. Neoplastic
Subsection A. General

47. Tumors of the Biliary Tree: Pathologic Features
Subsection B.  Benign Tumors

48. Benign Tumors and Pseudotumors of the Biliary Tract
Subsection C.  Malignant Tumors

49. Cancer of the Gallbladder
50 A. Cancer of the Bile Ducts: Intrahepatic Cholangiocarcinoma
50 B. Cancer of the Bile Ducts: Extrahepatic Biliary Tumors
50 C. Cancer of the Bile Ducts: Perihilar Cholangiocarcinoma with Emphasis on Presurgical Management
50 D. Cancer of the Bile Ducts: Interventional Techniques in Hilar and Intrahepatic Biliary Structures

Part 6.  Pancreatic Disease

Section I.  Inflammatory, Infective, and Congenital
Subsection A. Congenital Disorders

51. Congenital Disorders of the Pancreas: Surgical Considerations
Subsection B. Pancreatitis

52. Definition and Classification fo Pancreatitis
53. Etiology, Pathogenesis, and Diagnostic Assessment of Acute Pancreatitis
54. Managmeent of Acute Pancreatitis and Complications
55 A. Chronic Pancreatitis: Etiology, Pathogenesis, and Diagnosis
55 B. Management of Chronic Pancreatitis: Conservative, Endoscopic, and Surgical

Section II. Neoplastic
Subsection A. General

56. Pancreatic and Periampullary Tumors: Classification and Pathologic Features
Subsection B. Benign and Premalignant Tumors

57. Cystic Neoplasms of the Pancreas: Epidemiology, Clinical Features, ASsessment, and Management
Subsection C. Malignant Tumors
58 A. Epidemiology of Pancreatic Cancer
58 B. Pancreatic Cancer: Clinical Aspects, Assessment, and Management
59. Pancreatic Cancer: Duodenal Adenocarcinomas
60. The Pancreas as a Site of Metastatic Cancer
Subsection D. Endocrine Tumors
61. Endocrine Tumors of the Pancreas: Clinical Picture, Diagnosis, and Therapy
62 A. Resectional Techniques: Pancreaticoduodenectomy, Distal Pancreatectomy, Segmental Pancreatectomy, Total Pancreatectomy, and Transduodenal Resection of the Papilla of Vater
62 B. Surgery of the Pancreas: Minimally Invasive Approaches
63 A. Chemotherapy and Radiotherapy for Pancreatic and Periampullary Cancer: Adjuvant, Neoadjuvant, and Palliative
63 B. Palliation of Pancreatic and Periampullary Tumors

Volume II

Part 7: Hepatic Disease
Section I. Inflammatory, Infective, and Congenital
Subsection A. Hepatitis

64. Chronic Hepatitis: Epidemiology, Clinical Features, and Management
65. Hepatic Steatosis, Steatohepatitis, and Chemotherapy-Related Liver Injury
Subsection B. Liver Infection and INfestation

66. Pyogenic Liver Abcess
67. Amebiasis and Other Parasitic Infections
68. Hydatid Disease of the Liver
Subsection C. Nonparasitic Liver Cysts
69 A. Simple Cysts and Polycystic Liver Disease: Clinical and Radiographic Features
69 B. Simple Cysts and Polycystic Liver Disease: Surgical and Nonsurgical management
Subsection D. Hepatic Cirrhosis, Portal Hypertension, and Hepatic Failure

70 A. Cirrhosis and Portal Hypertension: Pathologic
70 B. Nonhepatic Surgery in the Cirrhotic Patient
71. Portal Hypertension in Children
72. Management of Liver Failure
73. Support of the Failing Liver
74. Management of Ascites in Cirrhosis and Portal Hypertension
75 A. Medical Management of Bleeding Varices: Primary and Secondary Prophylaxis
75 B. Esophageal Varices: Acute Management of Portal Hypertension
75 C. Esophageal Varices: Operative Devascularization and Splenectomy
76 A. Location of Portosystemic Shunting
76 B. Technique of Portocaval Shunting
76 C. Distal Splenorenal Shunt
76 D. Mesocaval Shunt
76 E. Transjugular Intrahepatic Portosystemic Shunting: Indications and Technique
77. Budd-Chiari Syndrome and Venoocclusive Disease

Section II: Neoplastic
Subsection A. General

78. Tumors of the Liver: Pathologic Aspects
Subsection B. Benign and Premalignant Tumors
79 A. Benign Liver Lesions
79 B. Cystic Hepatobiliary Neoplasia
Subsection C. Malignant Tumors
80. Hepatocellular Carcinoma
81 A. Metastatic Malignant Liver Tumors: Colorectal Cancer
81 B. Metastatic Malignant Liver Tumors: Neuroendocrine
81 C. Noncolorectal Nonneuroendocrine Metastases
82. Hepatic Tumors in Childhood
Subsection D. Treatment: Nonresectable

83. Hepatic Artery Embolization and Chemoembolization for Liver Tumors
84 A. Radioembolization for Liver Tumors
84 B. External-Beam Radiotherapy for Liver Tumors
85 A. Percutaneous Methods for Ablating Liver Tumors: Overview
85 B. Cryoablation for Liver Tumors
85 C. Radiofrequency Ablation for Liver Tumors
85 D. Microwave Ablation and Emerging Technologies for Liver Tumors
86. Regional Chemotherapy for Liver Tumors
87. Systemic Chemotherapy for Hepatic Colorectal Cancer: Impact on Surgical Management
88. Advances in Systemic Therapy for Hepatocellular Carcinoma
89. Isolated Hepatic Perfusion for Extensive Liver Cancer
Subsection E. Treatment: Resection

90 A. Hepatic Resection: General Considerations
90 B. Hepatic Resection for Benign Disease and for Liver and Biliary Tumors
90 C. Extended Hepatic Resection s for Biliary Tumors: An Alternative Approach
90 D. Hepatic Resection for Living Donor Transplantation
90 E. Minimally Invasive Techniques in Hepatic Resection
90 F. Liver Resection in Cirrhosis
91 A. Vascular Isolation
91 B. Vascular Reconstruction Techniques
92. Segment-Oriented Anatomic Liver Resections
93 A. Preoperative Portal Vein Embolization: Rationale, Indications, and Results
93 B. Preoperative Portal Vein Embolization: Technique
94. Ex Vivo and in Situ Hypothermic Hepatic Resection
95. Adjuncts to Hepatic Resection: Ultrasound and Emerging Guidance Systems

Part 8. Liver and Pancreas Transplanation

Section I.  General

96. Liver and Pancreas Transplantation Immunobiology

Section II. Indications

97 A. Liver Transplantation: Indications and General Considerations
97 B. Liver Transplantation: Anesthesia, Perioperative Management, and Postoperative Care
97 C. Liver Transplantation in Patients with Fulminant Hepatitis
97 D. Liver Transplantation for Hepatocellular Carcinoma
97 E. Liver Transplantation for Cholangiocarcinoma and Other Neoplastic Diseases

Section III.  Techniques

98 A. Orthotopic Liver Transplantation
98 B. Living Donor Liver Transplantation: Open and Laparoscopic
98 C. Liver Transplantation in Children and Segmental Transplantation
99. Techniques of Liver Replacement
100. Early and Later Complications of Liver Transplantation
101. Whole-Organ Pancreas and Pancreatic Islet Transplantation

Part 9.  Hepatobiliary Injury and Hemorrhage

102. Injuries to the Liver and Biliary Tract
103. Pancreatic and Duodenal Injuries
104. Aneurysm and Arteriovenous Fistula of the Liver and Pancreatic Vasculature
105. Hemobilia and Bilhemia


Video Contents:

Basic Hepatic Anatomy
Three-Dimensional Model

Techniques of Hepatic Resection

Inflow Control
Extrahepatic Approach, Right Hepatic Artery and Portal Vein
Extrahepatic Approach, Left Hepatic Artery and Portal Vein
Pedicle Ligation, Right Pedicle
Pedicle Ligation, Left Pedicle

Outflow Control
Right Hepatic Vein
Left and Middle Hepatic Veins
Left Hepatic Vein

Parenchymal Transection
Clamp Crushing
Water Jet

Major Hepatic Resections
Right Hemihepatectomy
Extended Right Hepatectomy
Left Hemihepatectomy
extended Left Hepatectomy

Segmental Resections
Left Lateral Segmentectomy, Segments 2 and 3
Right Posterior Sectorectomy, Segments 6 and 7
Central Hepectomy, Segments 4,5, and 8
Segment 3
Caudate Hepatectomy, Segement 1

Vascular and Biliary Resection
Reconstruction During Hepatectomy

Hepatic Tumors
Enucleation of Benign Hepatic Tumors

Biliary-0Enteric Anastomosis
Running Technique
Interrupted Technique

Resection for Biliary Malignancy
Left Hepatectomy with En Bloc Resection of the Bile Duct and Caudate Lobe
Right Hepatectomy with En Bloc Resection of the Bile Duct

Gallbladder Cancer
Porta Hepatitis Lymphadenecomy with Bile Duct Preservation for Incidental Gallbladder Cancer
Segmentectomy IVb/V for Gallbladder Cancer

Additional Techniques
Laparoscopic Right Hepatecomy
Pylorus-Preserving Pancreaticoduodenectomy for Adenocarconoma of the Pancreas
Central Pancreatectomy and Pancreatocogastrostomy for Pancreatic Endocrine Tumor
Laparoscopic Distal Pancreatectomy
Orthotopic Liver Transplantation
Resection from Living Donor Transplantation: Donor Right Hepatectomy Including the MHV

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