TY - CHAP M1 - Book, Section TI - Liver A1 - Cheng, Elaine Y. A1 - Zarrinpar, Ali A1 - Geller, David A. A1 - Goss, John A. A1 - Busuttil, Ronald W. A2 - Brunicardi, F. Charles A2 - Andersen, Dana K. A2 - Billiar, Timothy R. A2 - Dunn, David L. A2 - Hunter, John G. A2 - Matthews, Jeffrey B. A2 - Pollock, Raphael E. Y1 - 2015 N1 - T2 - Schwartz's Principles of Surgery, 10e AB - When operating on the liver, gallbladder, pancreas, or ­adjacent organs, recognition of the normal or variant vascular and biliary anatomy is essential to avoiding surgical ­complications.The liver is the largest gland in the body and performs a diverse spectrum of functions.Computed tomography and magnetic resonance imaging with contrast enhancement constitute the mainstays for the radiologic evaluation of the liver.Acute liver failure rapidly progresses to hepatic coma and death even with maximal medical therapy. The only definitive treatment is orthotopic liver transplantation.Cirrhosis is the end result of chronic hepatic insult, and further deterioration can lead to the development of end-stage liver disease, which carries a high mortality rate.Acute variceal bleeding should be managed with aggressive resuscitation and prompt endoscopic diagnosis with hemorrhage control. The transjugular intrahepatic portosystemic shunt procedure can be considered for cases refractory to medical treatment.Common benign lesions of the liver include cysts, hemangiomas, focal nodular hyperplasia, and hepatocellular ­adenomas. In most instances, these lesions can be reliably diagnosed by their characteristic features on imaging.Many options exist for the treatment of hepatocellular carcinomas, and these cases are best managed by a multidisciplinary liver transplant team.Surgical resection is the treatment of choice for hilar cholangiocarcinoma. Under a protocol with strict eligibility criteria, patients with unresectable tumors can be considered for liver transplantation following neoadjuvant chemoradiation, with survival rates that compare favorably with the rates for resection.The resectability of colorectal cancer metastases to the liver is primarily determined by the volume of the future liver remnant and the health of the background liver and not actual tumor number.Laparoscopic liver resections can be performed safely by experienced surgeons in selected patients and have been shown to produce comparable morbidity and mortality rates to open resections. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesssurgery.mhmedical.com/content.aspx?aid=1117750228 ER -