Hepatobiliary, pancreatic and splenic disease in children: medical and surgical management
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| Format: | Book |
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| Language: | English |
| Published: |
Amsterdam u.a.
Elsevier
1997
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| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XXVI, 605 S. Ill., graph. Darst. |
| ISBN: | 0444820523 |
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| 245 | 1 | 0 | |a Hepatobiliary, pancreatic and splenic disease in children |b medical and surgical management |c ed. by William F. Balistreri ... |
| 264 | 1 | |a Amsterdam u.a. |b Elsevier |c 1997 | |
| 300 | |a XXVI, 605 S. |b Ill., graph. Darst. | ||
| 336 | |b txt |2 rdacontent | ||
| 337 | |b n |2 rdamedia | ||
| 338 | |b nc |2 rdacarrier | ||
| 650 | 2 | |a Maladie des voies biliaires - Enfant | |
| 650 | 2 | |a Maladies du foie - Enfant | |
| 650 | 2 | |a Maladies du pancréas - Enfant | |
| 650 | 2 | |a Splénopathie - Enfant | |
| 650 | 4 | |a Biliary Tract Diseases | |
| 650 | 4 | |a Biliary tract |x Diseases | |
| 650 | 4 | |a Child | |
| 650 | 4 | |a Infant | |
| 650 | 4 | |a Liver Diseases | |
| 650 | 4 | |a Liver |x Diseases | |
| 650 | 4 | |a Pancreas |x Diseases | |
| 650 | 4 | |a Pancreatic Diseases | |
| 650 | 4 | |a Pediatric gastroenterology | |
| 650 | 4 | |a Spleen |x Diseases | |
| 650 | 4 | |a Splenic Diseases | |
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| adam_text | ix
Contents
Preface v
Foreword vii
Contributors xxiii
Chapter 1. Embryology of the Liver and Bile Ducts 1
Peter Van Eyken and Valeer J. Desmet
Introduction 1
1. Development of the liver parenchyma and intrahepatic bile ducts 1
1.1. Liver parenchyma 1
1.2. Intrahepatic bile ducts 2
1.3. Development of the peribiliary glands 5
1.4. Development of the peribiliary capillary plexus 5
2. Development of the extrahepatic bile ducts and the gallbladder 6
3. Sinusoids, sinusoidal cells and hepatic vasculature 7
4. Hematopoiesis 8
5. Hepatic growth and lobular development 9
References 9
Chapter 2. Embryology and Anatomy of the Pancreas and Pancreatic Ducts .... 15
Koichi Suda
1. Embryology of the pancreas and pancreatic ducts 15
1.1. Development of the ventral and dorsal pancreatic buds 15
1.2. Development of the pancreas and pancreatic ducts 15
1.3. Identification of the originating primordium 16
2. Anatomy and histology of the pancreas 16
2.1. Gross anatomy 16
2.2. Histology 17
3. Normal and anatomical variation of the pancreatic duct system 17
3.1. Normal and branch duct fusions between the dorsal pancreatic
duct and the right ventral pancreatic duct 17
3.2. So called pancreas divisums 18
3.3. Duct anomaly 20
References 20
Chapter 3. Functional Development of the Liver 21
Michael R. Narkewicz
Introduction 21
1. Carbohydrate metabolism 21
2. Amino acid metabolism 26
3. Bile formation and excretion 28
4. Developmental changes in hepatic zonation 29
References 31
Chapter 4. Physiology of Bilirubin Metabolism 37
Shoju Onishi, Susumu Itoh and Kenichi Isobe
Introduction 37
1. Bilirubin chemistry 39
1.1. Chemical structure of bilirubin 39
X
1.2. Enantiomerization of bilirubin 40
1.3. Bilirubin ionization and aqueous solubility 40
1.4. The interaction of bilirubin with membranes and phospholipids . ... 42
2. Bilirubin metabolism 43
2.1. Formation of bilirubin 43
2.2. Distribution of bilirubin 44
3. Hepatic metabolism 49
3.1. Hepatic uptake 49
3.2. Intracellular protein binding 52
3.3. Conjugation of bilirubin 52
4. Clinical problems in pediatrics 57
4.1. Neonatal jaundice 57
4.2. Bilirubin metabolism during jaundice phototherapy 59
5. Pathophysiological significance of neonatal jaundice 62
References 66
Chapter 5. Physiology of Bile Acid Metabolism 71
Eric A. Argao and William F. Balistreri
Introduction 71
1. Chemistry 71
2. Synthesis and metabolism 72
3. Physiological function of bile acids 76
4. Immaturity of bile acid metabolism in the fetus and newborn 76
5. Bile acid malabsorption and diarrhea 78
6. Inborn errors of bile acid synthesis and metabolism 79
References 82
Chapter 6. The Role of Liver Biopsy in the Evaluation of the Child with
Hepatobiliary Disease 89
J.T. Stocker
Introduction 89
1. Extrahepatic biliary atresia 90
2. Idiopathic neonatal hepatitis 93
3. Alpha 1 antitrypsin deficiency 94
4. Gaucher s disease 95
5. Niemann Pick disease 96
6. Galactosemia, fructosemia, tyrosinemia 97
7. Paucity of intrahepatic bile ducts 98
8. Wilson s disease 98
9. Cystic fibrosis 100
10. Cytomegalovirus 101
11. Herpes simplex virus 102
12. Infantile polycystic kidney/liver disease — congenital hepatic fibrosis . . . 103
13. Neonatal iron storage disease 104
References 105
Chapter 7. The Role of Imaging in the Evaluation of the Child with Hepatobiliary
Disease
Part 1: Ultrasound 107
Shin itsu Hatakeyama and Yoshiaki Tsuchida
Introduction 107
1. Instruments 107
2. Anesthesia 110
3. Efficacy of US Ill
xi
4. Other applications of US 112
4.1. US Guided puncture procedures 112
4.2. Operative US 112
4.3. DopplerUS 112
References 112
Part 2: Scintigraphy 113
John D. Strain
Introduction 113
1. Historical aspects 113
2. Radiopharmaceuticals 114
2.1. Hepatobiliary agents (iminodiacetic acid) 114
2.2. Technetium 99m sulfur colloid 116
2.3. Technetium mTc denatured red blood cells 116
3. Methodology and pharmacologic intervention 117
4. Clinical applications 118
4.1. Hepatobiliary agents (iminodiacetic acid) 118
4.2. 99mTc Sulfur colloid imaging 120
4.3. Denatured red blood cell imaging 122
5. Conclusion 124
References 124
Part 3: Magnetic Resonance Imaging/Computerized Tomography 127
Ehiichi Khoda, Hiromi Hisazumi and Hiroya Yamazaki
Introduction 127
1. Liver 128
1.1. Differential diagnosis of liver masses 128
1.2. Liver abscess 128
1.3. Hepatoblastoma 129
1.4. Hepatocellular carcinoma 130
1.5. Hepatic adenoma 133
1.6. Focal nodular hyperplasia 134
1.7. Mesenchymal hamartoma 134
1.8. Undifferentiated sarcoma 134
1.9. Infantile hepatic hemangioendothelioma 135
1.10. Congenital anomalies of the biliary tract 136
2. Pancreas 137
2.1. Pancreatitis 137
2.2. Pancreatoblastoma 137
2.3. Solid and cystic tumor of the pancreas 138
2.4. Pancreatic adenocarcinoma 138
2.5. Islet cell tumor 139
3. Conclusions 139
References 140
Part 4: Percutaneous Transhepatic Cholangiography 143
Toshihiro Muraji and Kimio Kanegawa
Introduction 143
1. Techniques 144
1.1. The Seldinger technique 144
1.2. The trocar technique 144
2. Indications 145
3. Conclusions 147
References 148
xii
Part 5: Endoscopic Retrograde Cholangiopancreatography 149
Naomi Ohnuma and Hideyo Takahashi
Introduction 149
1. Indications for ERCP examination 149
2. Instruments 150
3. Anesthesia 150
4. Details of the procedure 150
5. ERCP findings in congenital biliary dilatation 151
6. ERCP findings in biliary atresia 152
7. Success rate and complications of ERCP 153
References 154
Chapter 8. Neonatal Cholestasis: Differential Diagnosis, Evaluation, and
Management 157
Jay A. Hochman and William F. Balistreri
Introduction 157
1. Neonatal cholestasis: definition 157
2. Epidemiology 158
3. Differential diagnosis 159
3.1. Evaluation 159
3.2. History and physical exam 162
3.3. Laboratory evaluation 163
3.4. Radiographic evaluation 164
3.5. Liver biopsy 165
3.6. Intraoperative cholangiogram 165
4. Specific disorders 166
4.1. Treatable diseases 166
4.2. Idiopathic infantile cholangiopathies 167
4.3. Biliary atresia 168
4.4. Neonatal hepatitis 172
4.5. Metabolic liver diseases 174
4.6. Total parenteral nutrition associated cholestasis (TPN AC) 175
4.7. The medical management of chronic cholestasis 178
5. Summary 183
References 183
Chapter 9. Maternal Transmission of Hepatitis 193
Kazuo Shiraki, Ikuo Nagata and Toshiyuki Iizuka
Introduction 193
1. Hepatitis B 193
1.1. Epidemiology of mother to infant infection of HBV 194
1.2. Prevention of mother to infant transmission of HBV with hepatitis
B hyperimmune globulin and hepatitis B vaccine 195
2. Hepatitis C 196
2.1. Incidence and risk factors for mother to infant transmission of HCV 196
2.2. Outcome of HCV infected infants 198
3. Conclusions 198
References 198
Chapter 10. Clinical Aspects of Inborn Errors of Metabolism 201
David A. Weichmann and William F. Balistreri
Introduction 201
1. Overview 201
2. Alpha 1 antitrypsin deficiency (AATD) 203
xiii
2.1. Pathophysiology 203
2.2. Clinical features 204
2.3. Histology 204
2.4. Diagnosis 205
2.5. Treatment 205
3. Disorders of galactose metabolism 206
3.1. Pathophysiology 206
3.2. Clinical features 206
3.3. Diagnosis 207
3.4. Treatment 207
4. Disorders of fructose metabolism 208
4.1. Pathophysiology 208
4.2. Clinical presentation 209
4.3. Diagnosis 209
4.4. Treatment 209
5. Neonatal hemochromatosis 210
5.1. Pathophysiology 210
5.2. Clinical presentation 210
5.3. Histology 211
5.4. Diagnosis 211
5.5. Treatment 211
6. Tyrosinemia 211
6.1. Pathophysiology 212
6.2. Clinical presentation 212
6.3. Histology 213
6.4. Diagnosis 213
6.5. Treatment 213
7. Wilson s disease 214
7.1. Pathophysiology 214
7.2. Clinical presentation 215
7.3. Histology 215
7.4. Diagnosis 216
7.5. Treatment 217
8. Bile acid biosynthesis defects 218
8.1. Diagnosis 218
8.2. Treatment 219
9. Disorders of fatty acid oxidation 219
9.1. Pathophysiology 219
9.2. Diagnosis 221
9.3. Treatment 221
10. Mitochondrial hepatopathies 222
References 223
Chapter 11. Biliary Atresia 231
Ryoji Ohi
Introduction 231
1. General considerations 232
2. Etiology 233
3. Pathology 234
3.1. Pathology of extrahepatic bile ducts 234
3.2. Pathology of intrahepatic bile ducts 235
3.3. Pathology of liver 237
3.4. Morphological classification of extrahepatic bile ducts 237
4. Signs and symptoms 239
xiv
5. Diagnosis 240
5.1. Special biochemical studies 240
5.2. Tests to confirm the patency of the bile ducts 242
5.3. Direct cholangiography 242
6. Surgical treatment 242
6.1. Hepatico enterostomy 243
6.2. Hepatic portoenterostomy (Kasai procedure) 243
6.3. Liver transplantation 251
7. Results of hepatic portoenterostomy 252
7.1. Predictor of clinical outcome 252
7.2. Early postoperative results 252
7.3. Long term results 253
8. Summary 254
References 254
Chapter 12. Choledochal Cysts and Pancreatobiliary Maljunction 261
Takuji Todani
Introduction 261
1. Historical aspects 261
2. Classification of choledochal cysts 262
3. Pancreatobiliary malunion 264
4. Etiology 265
5. Pathology 267
6. Pathophysiology of malunion 268
6.1. Biliary disorders 268
6.2. Pancreatic disorders 271
6.3. Hepatic disorders 272
7. Clinical features 272
7.1. Infants 273
7.2. Older children 273
8. Diagnosis 273
9. Prognosis 274
10. Treatment 275
10.1. Types I and IV A cysts 276
10.2. Type II cyst 276
10.3. Type III cyst (choledochocele) 276
10.4. Type IV B cyst 276
10.5. Type V cyst and Caroli s disease 276
11. Excisional surgery 276
11.1. Cyst excision 277
11.2. Biliary reconstruction 277
11.3. Surgical complications 279
References 282
Chapter 13. Caroli s Disease 287
Yoshiaki Tsuchida
Introduction 287
1. Symptoms 287
2. Pathology 288
3. Diagnosis 289
4. Treatment and prognosis 290
5. Complications 291
References 291
XV
Chapter 14. Gallbladder Diseases 293
Akio Kubota and Akira Okada
Introduction 293
1. Congenital anomalies 293
2. Cholelithiasis and its complications 294
2.1. Etiology 294
2.2. Clinical features 296
2.3. Treatment 297
3. Acalculous gallbladder disease 298
3.1. Etiology 298
3.2. Clinical features 298
3.3. Treatment 299
References 299
Chapter 15. Portal Hypertension 303
Edward R. Howard
1. Definition 303
2. Embryology of the portal venous system 303
3. Presentation and aetiology 304
3.1. Cirrhotic disease 305
3.2. Extrahepatic portal vein obstruction 305
3.3. Hepatoportal sclerosis 307
3.4. Budd Chiari syndrome 308
3.5. Congenital hepatic artery portal vein fistula 309
4. Investigation 310
5. Acute treatment 311
5.1. Management of acute variceal haemorrhage 311
6. Long term treatment 312
6.1. Injection sclerotherapy 312
6.2. Banding of varices 316
6.3. Portosystemic shunt procedures 317
6.4. Non shunt surgery 322
6.5. Transjugular intrahepatic portosystemic stent shunt 324
6.6. Transplantation 325
References 325
Chapter 16. Malignant Liver and Bile Duct Tumors 331
Yoshiaki Tsuchida
Introduction 331
1. Pathology 331
1.1. Hepatoblastoma 332
1.2. Hepatocellular carcinoma 335
1.3. Fibrolamellar hepatocellular carcinoma 335
1.4. Mesenchymoma 335
1.5. Other primary malignant tumors 336
1.6. Metastatic tumors 336
2. Clinical aspects 337
2.1. Symptoms 337
2.2. Laboratory investigation 337
2.3. Radiological investigation 338
3. Treatment 339
3.1. Surgical resection 339
3.2. Chemotherapy 341
3.3. Intra arterial infusion chemotherapy and embolization 342
xvi
4. Clinical results 343
5. Malignant bile duct tumors 343
References 344
Chapter 17. Benign Liver Tumors and Cysts 349
Yoshiaki Tsuchida
Introduction 349
1. Mesenchymal hamartoma 349
2. Focal nodular hyperplasia 351
3. Hemangiomas 353
4. Non parasitic cyst 354
References 355
Chapter 18. Liver Abscess and Parasitic Infestations 359
Yoshinobu Hata and Fumiaki Sasaki
Introduction 359
1. Liver abscess 359
1.2. Etiology 359
1.2. Pathology 360
1.3. Clinical features 360
1.4. Diagnosis 360
1.5. Treatment and prognosis 361
2. Amebic liver abscess 362
2.1. Etiology 362
2.2. Pathology 362
2.3. Clinical features and diagnosis 362
2.4. Treatment and prognosis 362
3. Hydatid disease of the liver 363
3.1. Etiology 363
3.2. Pathology 363
3.3. Clinical features and diagnosis 363
3.4. Treatment and prognosis 363
4. Conclusions 364
References 365
Chapter 19. Liver Trauma 367
Victor F. Garcia
Introduction 367
1. Epidemiology 367
2. Mortality of abdominal traumatic injury 368
3. History and physical examination 368
3.1. Mechanisms and patterns of injury 368
3.2. Pathophysiology 369
3.3. Hepatic anatomy 370
3.4. Liver injury classification 371
3.5. Physical examination 372
4. Diagnosis 372
4.1. Laboratory 372
4.2. Radiography 373
4.3. Diagnostic peritoneal lavage 373
4.4. Emergent laparoscopy 373
4.5. Computer tomographic scanning 374
4.6. Ultrasonography 375
4.7. Scintigraphy 375
xvii
4.8. Angiography 376
5. Nonoperative management 376
6. Operative management 377
7. Operative technique 379
7.1. Massive bleeding 379
7.2. Complications 382
References 384
Chapter 20. Liver Transplantation (Cadaveric) 391
Frederick C. Ryckman and Maria H. Alonso
Introduction 391
1. The selection process 392
1.1. Indications 392
1.2. Neonatal cholestatic syndromes 392
1.3. Metabolic disease 394
1.4. Fulminant hepatic failure 394
1.5. Malignancy 396
1.6. Contraindications 397
1.7. Prioritization 397
2. Pre operative preparation 397
3. Operative treatment 398
3.1. Donor options 398
3.2. Orthotopic transplant techniques 398
4. The transplant procedure 403
5. Immunosuppressive management 406
6. Post operative complications 408
6.1. Primary non function 409
6.2. Vascular thrombosis 411
6.3. Biliary complications 413
7. Rejection 415
7.1. Acute cellular rejection 415
7.2. Chronic rejection 416
7.3. Infection 417
7.4. Epstein Barr virus infection — post transplant
lymphoproliferative disease 419
8. Outcome following transplantation 422
9. Retransplantation 423
10. Follow up 423
11. Nutrition and growth 423
12. Neuropsychological outcome 424
13. Future issues in transplantation 425
References 425
Chapter 21. Liver Transplantation from Living Donors 433
Hideo Kawarasaki, Masatoshi Makuuchi and Seiji Kawasaki
Introduction 433
1. History of LTLD 433
2. Indications and contraindications for LTLD 434
2.1. Recipients 434
2.2. Donors 435
3. Preoperative care, examinations, and preparations 435
3.1. Recipients 436
3.2. Donors 437
4. Surgical procedure 438
xviii
4.1. Recipients 438
4.2. Donors 439
4.3. Back table preparation of the graft and vessels 439
4.4. Anastomosis of the vessels and hepatic duct 440
5. Postoperative care and complications 440
5.1. Vascular complications 440
5.2. Rejection and immunosuppression 441
5.3. Infection 441
6. Results 443
References 443
Chapter 22. Evaluation of Pancreatic Disease 447
Yusaku Tazawa and Tasuke Konno
Introduction 447
1. Overview 447
2. Natural history, physical and laboratory examinations 448
3. Imaging procedures 449
4. Pancreatic function tests 450
4.1. Direct tests of exocrine pancreatic functions 451
4.2. Indirect tests of exocrine pancreatic functions 451
5. Blood tests 453
6. Histological examination 454
References 454
Chapter 23. Cystic Fibrosis: Pancreatic, Hepatic, and Intestinal
Manifestations 459
Robert J. Rothbaum
Introduction 459
1. Pancreatic dysfunction 460
1.1. Basic defects associated with CFTR dysfunction 460
1.2. Clinical effects of exocrine pancreatic insufficiency 460
1.3. Diagnosis of exocrine pancreatic insufficiency 461
1.4. Treatment of exocrine pancreatic insufficiency in CF 461
1.5. Limitations of supplemental pancreatic enzymes in CF 463
1.6. Approaches to improve the effectiveness of pancreatic enzymes . . . 464
1.7. Diet and vitamin supplementation in CF 466
1.8. Monitoring of efficacy of supplemental pancreatic enzyme therapy . 466
1.9. Pancreatitis 467
2. Hepatobiliary disease in cystic fibrosis 468
2.1. Basic defects associated with CFTR dysfunction in the liver 468
2.2. Spectrum of hepatic dysfunction in CF 468
2.3. Medical therapy of CF related liver disease 470
3. Liver disorders coincident with and contributing to CF related liver
disease 470
4. Biliary tract disease in CF 471
4.1. Microgallbladder 471
4.2. Cholelithiasis 471
5. Bile duct disorders 471
6. Intestinal disorders in cystic fibrosis 471
7. Neonatal disorders 472
8. Meconium ileus equivalent or distal intestinal obstruction syndrome . . . 473
9. Summary 474
References 474
xix
Chapter 24. Pancreatitis 479
Peter A.M. Raine
Introduction 479
1. Incidence 479
2. Classification, aetiology and pathology 479
3. Presentation 482
4. Investigation and diagnosis 483
4.1. Biochemical investigations 483
4.2. Radiological investigations 484
5. Medical management 488
5.1. Resuscitation and supportive treatment 488
5.2. Elimination of the underlying cause 488
5.3. Specific therapy directed against the pancreatitis process 488
6. Surgical management 489
7. Complications 490
7.1. Complications due to the inflammatory process 490
7.2. Complications due to pancreatic damage 491
8. Prognosis 491
References 492
Chapter 25. Pancreatic Trauma 495
Marc S. Arkovitz and Victor Garcia
Introduction 495
1. Etiology 495
2. Diagnosis 497
2.1. Laboratory evaluation 498
2.2. Diagnostic peritoneal lavage 498
2.3. Radiologic imaging 499
3. Classification and treatment 502
4. Complications and their treatment 506
5. Conclusion 507
References 507
Chapter 26. Nesidioblastosis and Insulinoma: Islet Cell Dysplasia 511
Daniel von Allmen and Moritz M. Ziegler
Introduction 511
1. Embryology 512
2. Clinical presentation 513
3. Diagnosis 514
4. Treatment 514
5. Results 516
6. Summary 517
References 517
Chapter 27. Pancreatic Tumors 521
Takuji Todani
Introduction 521
1. Non endocrine tumors 522
1.1. Pancreatoblastoma 522
1.2. Pancreatic carcinoma 523
1.3. Frantz s tumor (papillary and cystic tumor of the pancreas) 524
2. Endocrine tumors 526
2.1. Gastrinoma (Zollinger Ellison Syndrome) 527
2.2. Vipoma (WDHA syndrome) 528
XX
2.3. Multiple endocrine neoplasia type I (MEN I) 528
2.4. Glucagonoma and somatostatinoma 528
3. Non epithelial tumors 528
References 529
Chapter 28. Embryology and Congenital Abnormalities of the Spleen 533
Wayne E. Vander Kolk and Moritz M. Ziegler
Introduction 533
1. Embryology 533
2. Topography of the spleen 535
3. Congenital splenic anomalies 536
4. Situs inversus viscerum 536
5. Asplenia 536
6. Simple agenesis of the spleen 538
7. Agenesis of the spleen with cardiac and symmetric defects (asplenia
syndrome) 538
8. Splenic hypoplasia 538
9. Accessory spleens 538
10. Splenogonadal fusion 539
11. The polysplenia syndrome 542
12. Wandering spleen 543
13. Neonatal splenic rupture 545
14. Congenital cyst 546
15. Splenic hemangioma 547
References 547
Chapter 29. Diseases of Spleen and Indications for Splenectomy 553
Charles J.H. Stolar and James Stein
Introduction 553
1. Staging laparotomy for hodgkin s lymphoma 553
2. Trauma 555
3. Hematologic disorders 558
3.1. Red cell disorders 558
3.2. Hemoglobinopathies 559
3.3. Immune anemia 560
3.4. Enzyme defects 560
3.5. Immune thrombocytopenias 560
3.6. Wiskott Aldrich 560
3.7. Other causes of hypersplenism 561
4. Malignancies 562
5. Benign tumors and cysts 562
6. Infection 564
7. Congenital anomalies 564
7.1. Wandering spleen 564
7.2. Splenic gonadal fusion 564
7.3. Polysplenia 564
8. Techniques of splenectomy and splenic reduction 564
8.1. Pre op vaccination and postoperative antibiotics 564
8.2. Splenectomy 565
8.3. Laparoscopic splenectomy 565
8.4. Partial splenectomy 566
8.5. Wrapping/repair 566
8.6. Embolization 567
References 567
xxi
Chapter 30. Post Splenectomy Complications 571
Kota Okinaga
Introduction 571
1. Early complications 571
1.1. Respiratory complications 571
1.2. Postoperative bleeding 572
1.3. Injury to the tail of the pancreas and to the greater curvature
of the stomach 572
1.4. Pancreatitis 573
1.5. Subphrenic abscess 573
2. Late complications 573
2.1. Thrombocytosis and thrombotic complications 573
2.2. Infectious complications 574
References 576
Chapter 31. Partial Splenic Embolization and Autotransplantation of the Spleen 579
Toshio Chiba and Ryoji Ohi
Introduction 579
1. Partial splenic embolization (PSE) — its significance in the
management of pediatric disorders associated with hypersplenism .... 580
1.1. History 580
1.2. Technique of PSE 580
1.3. Hemodynamic alterations after PSE 581
1.4. Long term follow up 582
1.5. Complications of PSE 583
1.6. Experience at Tohoku University Hospital, 1984 1995 583
1.7. The role of PSE in patients with portal hypertension 586
1.8. Conclusions 586
2. Splenic autotransplantation 586
2.1. History 586
2.2. Method and anatomic sites of splenic autotransplantation 587
2.3. Functional and morphological studies of regenerating splenic
autograft 587
2.4. Evaluation of autogenous heterotopic transplantation of the spleen . 588
2.5. Autograft size and relevant kinetics of regeneration 588
2.6. Indications for splenic autotransplantation 589
2.7. Complications 589
2.8. Autotransplantation versus splenic conservation 589
2.9. Conclusions 589
References 589
Subject index 593
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| callnumber-raw | RJ446 |
| callnumber-search | RJ446 |
| callnumber-sort | RJ 3446 |
| callnumber-subject | RJ - Pediatrics |
| classification_rvk | YQ 4515 |
| ctrlnum | (OCoLC)36352650 (DE-599)BVBBV012001060 |
| dewey-full | 618.92/36 |
| dewey-hundreds | 600 - Technology (Applied sciences) |
| dewey-ones | 618 - Gynecology, obstetrics, pediatrics, geriatrics |
| dewey-raw | 618.92/36 |
| dewey-search | 618.92/36 |
| dewey-sort | 3618.92 236 |
| dewey-tens | 610 - Medicine and health |
| discipline | Medizin |
| format | Book |
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| genre | (DE-588)4143413-4 Aufsatzsammlung gnd-content |
| genre_facet | Aufsatzsammlung |
| id | DE-604.BV012001060 |
| illustrated | Illustrated |
| indexdate | 2024-07-09T18:19:57Z |
| institution | BVB |
| isbn | 0444820523 |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-008120561 |
| oclc_num | 36352650 |
| open_access_boolean | |
| owner | DE-355 DE-BY-UBR |
| owner_facet | DE-355 DE-BY-UBR |
| physical | XXVI, 605 S. Ill., graph. Darst. |
| publishDate | 1997 |
| publishDateSearch | 1997 |
| publishDateSort | 1997 |
| publisher | Elsevier |
| record_format | marc |
| spelling | Hepatobiliary, pancreatic and splenic disease in children medical and surgical management ed. by William F. Balistreri ... Amsterdam u.a. Elsevier 1997 XXVI, 605 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Maladie des voies biliaires - Enfant Maladies du foie - Enfant Maladies du pancréas - Enfant Splénopathie - Enfant Biliary Tract Diseases Biliary tract Diseases Child Infant Liver Diseases Pancreas Diseases Pancreatic Diseases Pediatric gastroenterology Spleen Diseases Splenic Diseases Kind (DE-588)4030550-8 gnd rswk-swf Milzkrankheit (DE-588)4122284-2 gnd rswk-swf Bauchspeicheldrüsenkrankheit (DE-588)4004727-1 gnd rswk-swf Leberkrankheit (DE-588)4034937-8 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Milzkrankheit (DE-588)4122284-2 s Kind (DE-588)4030550-8 s DE-604 Leberkrankheit (DE-588)4034937-8 s Bauchspeicheldrüsenkrankheit (DE-588)4004727-1 s Balistreri, William F. Sonstige oth HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008120561&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Hepatobiliary, pancreatic and splenic disease in children medical and surgical management Maladie des voies biliaires - Enfant Maladies du foie - Enfant Maladies du pancréas - Enfant Splénopathie - Enfant Biliary Tract Diseases Biliary tract Diseases Child Infant Liver Diseases Pancreas Diseases Pancreatic Diseases Pediatric gastroenterology Spleen Diseases Splenic Diseases Kind (DE-588)4030550-8 gnd Milzkrankheit (DE-588)4122284-2 gnd Bauchspeicheldrüsenkrankheit (DE-588)4004727-1 gnd Leberkrankheit (DE-588)4034937-8 gnd |
| subject_GND | (DE-588)4030550-8 (DE-588)4122284-2 (DE-588)4004727-1 (DE-588)4034937-8 (DE-588)4143413-4 |
| title | Hepatobiliary, pancreatic and splenic disease in children medical and surgical management |
| title_auth | Hepatobiliary, pancreatic and splenic disease in children medical and surgical management |
| title_exact_search | Hepatobiliary, pancreatic and splenic disease in children medical and surgical management |
| title_full | Hepatobiliary, pancreatic and splenic disease in children medical and surgical management ed. by William F. Balistreri ... |
| title_fullStr | Hepatobiliary, pancreatic and splenic disease in children medical and surgical management ed. by William F. Balistreri ... |
| title_full_unstemmed | Hepatobiliary, pancreatic and splenic disease in children medical and surgical management ed. by William F. Balistreri ... |
| title_short | Hepatobiliary, pancreatic and splenic disease in children |
| title_sort | hepatobiliary pancreatic and splenic disease in children medical and surgical management |
| title_sub | medical and surgical management |
| topic | Maladie des voies biliaires - Enfant Maladies du foie - Enfant Maladies du pancréas - Enfant Splénopathie - Enfant Biliary Tract Diseases Biliary tract Diseases Child Infant Liver Diseases Pancreas Diseases Pancreatic Diseases Pediatric gastroenterology Spleen Diseases Splenic Diseases Kind (DE-588)4030550-8 gnd Milzkrankheit (DE-588)4122284-2 gnd Bauchspeicheldrüsenkrankheit (DE-588)4004727-1 gnd Leberkrankheit (DE-588)4034937-8 gnd |
| topic_facet | Maladie des voies biliaires - Enfant Maladies du foie - Enfant Maladies du pancréas - Enfant Splénopathie - Enfant Biliary Tract Diseases Biliary tract Diseases Child Infant Liver Diseases Pancreas Diseases Pancreatic Diseases Pediatric gastroenterology Spleen Diseases Splenic Diseases Kind Milzkrankheit Bauchspeicheldrüsenkrankheit Leberkrankheit Aufsatzsammlung |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008120561&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
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