The Operative Standards for Cancer Surgery manuals provide evidence-based recommendations for the proper technical conduct of cancer surgery. Presented by the American College of Surgeons, Operative Standards for Cancer Surgery: Sarcoma, Adrenal, Neuroendocrine, Peritoneal Malignancies, Urothelial, Hepatobiliary helps surgeons distill the latest evidence into best practices and techniques that lead to improved outcomes. Focused on the steps between skin incision and skin closure, this manual is an invaluable resource for surgical oncologists and general surgeons alike.
1. INTRODUCTION - p. 1 2. CLINICAL STAGING - p. 2 3. MULTIDISCIPLINARY CARE - p. 9 4. PERIOPERATIVE CARE - p. 11 5. QUALITY MEASURES - p. 13 6. CHAPTER 1: Resection of Extremity and Trunk Soft Tissue Sarcoma - p. 14 7. CRITICAL ELEMENTS - p. 14 8. 1. PRETREATMENT BIOPSY OF SOFT TISSUE MASSES OF THE EXTREMITY AND TRUNK - p. 14 9. 2. MACROSCOPICALLY COMPLETE RESECTION OF THE PRIMARY TUMOR - p. 17 10. 3. PLACEMENT OF SURGICAL DRAINS - p. 26 11. INTRODUCTION - p. 28 12. METHODOLOGY - p. 28 13. FINDINGS - p. 30 14. CONCLUSION - p. 39 15. CHAPTER 2: Resection of Retroperitoneal and Intra-Abdominal Soft Tissue Sarcoma - p. 40 16. CRITICAL ELEMENTS - p. 40 17. 1. MACROSCOPICALLY COMPLETE RESECTION OF PRIMARY TUMOR WITHOUT DISRUPTION OF TUMOR CAPSULE - p. 40 18. 2. EN BLOC RESECTION OF INVADED ORGANS TO OBTAIN A COMPLETE GROSS RESECTION - p. 42 19. INTRODUCTION - p. 48 20. METHODOLOGY - p. 48 21. FINDINGS - p. 50 22. CONCLUSION - p. 61 23. Synoptic Operative Report: Extremity Sarcoma - p. 68 24. Synoptic Operative Report: Retroperitoneal Sarcoma - p. 68 25. COMMENTARY: SARCOMA SECTION - p. 71 26. SECTION II. ADRENAL - p. 73 27. INTRODUCTION - p. 73 28. CLINICAL STAGING - p. 74 29. MULTIDISCIPLINARY CARE - p. 75 30. PERIOPERATIVE CARE - p. 76 31. QUALITY MEASURES - p. 82 32. CHAPTER 3: Adrenalectomy Including Multivisceral Resection - p. 83 33. CRITICAL ELEMENTS - p. 83 34. 1. RESECTION OF THE PRIMARY TUMOR TO MICROSCOPICALLY NEGATIVE MARGINS WITHOUT DISRUPTION OF THE TUMOR CAPSULE - p. 83 35. 2. EN BLOC RESECTION OF ADJACENT ORGANS DIRECTLY INVADED BY CANCER - p. 88 36. INTRODUCTION - p. 91 37. METHODOLOGY - p. 91 38. FINDINGS - p. 98 39. CONCLUSION - p. 102 40. CHAPTER 4: Vascular Invasion - p. 103 41. CRITICAL ELEMENTS - p. 103 42. 1. EN BLOC RESECTION OF ADJACENT BLOOD VESSELS DIRECTLY INVOLVED BY PRIMARY TUMOR AND/OR TUMOR THROMBUS - p. 103 43. INTRODUCTION - p. 110 44. METHODOLOGY - p. 110 45. FINDINGS - p. 112 46. CONCLUSION - p. 114 47. CHAPTER 5: Lymphadenectomy - p. 116 48. CRITICAL ELEMENTS - p. 116 49. 1. RESECTION OF REGIONAL LYMPH NODES INVOLVED BY METASTATIC ADRENAL CANCER - p. 116 50. INTRODUCTION - p. 120 51. METHODOLOGY - p. 120 52. FINDINGS - p. 126 53. CONCLUSION - p. 128 54. Synoptic Operative Report: Adrenal - p. 135 55. COMMENTARY: ADRENAL SECTION - p. 141 56. SECTION III. NEUROENDOCRINE - p. 143 57. INTRODUCTION - p. 143 58. CLINICAL STAGING - p. 147 59. MULTIDISCIPLINARY CARE - p. 147 60. PERIOPERATIVE CARE - p. 154 61. QUALITY MEASURES - p. 154 62. CHAPTER 6: Small Bowel Resection - p. 156 63. CRITICAL ELEMENTS - p. 156 64. 1. INTRAOPERATIVE EVALUATION AND IDENTIFICATION OF PRIMARY TUMOR(S) - p. 156 65. 2. REGIONAL LYMPHADENECTOMY ALONG SEGMENTAL VESSELS - p. 160 66. 3. RESECTION OF THE PRIMARY TUMOR - p. 164 67. INTRODUCTION - p. 166 68. METHODOLOGY - p. 166 69. FINDINGS - p. 167 70. CONCLUSION - p. 173 71. INTRODUCTION - p. 174 72. METHODOLOGY - p. 175 73. FINDINGS - p. 175 74. CONCLUSION - p. 178 75. CHAPTER 7: Parenchyma-Preserving Pancreatectomy - p. 179 76. CRITICAL ELEMENTS - p. 179 77. 1. INTRAOPERATIVE ULTRASOUND PRIOR TO ENUCLEATION - p. 179 78. 2. RESECTION OF THE PRIMARY TUMOR - p. 180 79. 3. REGIONAL LYMPH NODE SAMPLING OF THE PERIPANCREATIC AND CELIAC LYMPH NODES - p. 183 80. INTRODUCTION - p. 185 81. METHODOLOGY - p. 185 82. FINDINGS - p. 187 83. CONCLUSION - p. 198 84. Synoptic Operative Report: Pancreatic Neuroendocrine Tumor - p. 209 85. Synoptic Operative Report: Small Bowel Neuroendocrine Tumor - p. 209 86. COMMENTARY: NEUROENDOCRINE SECTION - p. 211 87. SECTION IV. PERITONEAL MALIGNANCIES - p. 215 88. INTRODUCTION - p. 215 89. CLINICAL STAGING - p. 216 90. MULTIDISCIPLINARY CARE - p. 219 91. PERIOPERATIVE CARE - p. 219 92. QUALITY MEASURES - p. 221 93. CHAPTER 8: Cytoreduction - p. 223 94. CRITICAL ELEMENTS - p. 223 95. 1. SUPRACOLIC GREATER OMENTECTOMY - p. 223 96. 2. RESECTION OF MESENTERIC DISEASE - p. 227 97. 3. CYTOREDUCTION OF THE DIAPHRAGM - p. 228 98. 4. CYTOREDUCTION WITHIN THE PELVIS - p. 233 99. 5. ABDOMINAL VISCERAL RESECTIONS - p. 239 100. CHAPTER 9: Drug Delivery and Safety - p. 249 101. CRITICAL ELEMENTS - p. 249 102. 1. HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY FOLLOWING CYTOREDUCTION - p. 249 103. INTRODUCTION - p. 254 104. METHODOLOGY - p. 255 105. FINDINGS - p. 256 106. CONCLUSION - p. 268 107. INTRODUCTION - p. 269 108. METHODOLOGY - p. 269 109. FINDINGS - p. 271 110. CONCLUSION - p. 273 111. Synoptic Operative Report: Peritoneal - p. 283 112. COMMENTARY: PERITONEAL SECTION - p. 286 113. SECTION V. UROTHELIAL - p. 290 114. INTRODUCTION - p. 291 115. CLINICAL STAGING - p. 292 116. MULTIDISCIPLINARY CARE - p. 294 117. PERIOPERATIVE CARE - p. 301 118. QUALITY MEASURES - p. 302 119. CHAPTER 10: Endoscopic Management - p. 303 120. CRITICAL ELEMENTS - p. 303 121. 1. ENDOSCOPIC EVALUATION OF URETHRA AND BLADDER - p. 303 122. 2. TRANSURETHRAL RESECTION OF BLADDER TUMOR - p. 306 123. 3. ENDOSCOPIC EVALUATION AND TREATMENT OF UPPER TRACT DISEASE - p. 308 124. 4. POSTOPERATIVE INSTILLATION OF INTRAVESICAL CHEMOTHERAPY - p. 311 125. CHAPTER 11: Partial Cystectomy - p. 313 126. CRITICAL ELEMENTS - p. 313 127. 1. INTRAOPERATIVE LOCALIZATION OF TUMOR - p. 313 128. 2. RESECTION TO ADEQUATE MARGINS - p. 315 129. CHAPTER 12: Radical Cystectomy - p. 319 130. CRITICAL ELEMENTS - p. 319 131. 1. REMOVAL OF BLADDER TO NEGATIVE RESECTION MARGINS - p. 319 132. 2. CONCOMITANT PELVIC ORGAN MANAGEMENT IN MEN AND WOMEN - p. 323 133. 3. PELVIC LYMPH NODE DISSECTION - p. 329 134. 4. SELECTION OF A URINARY DIVERSION PROCEDURE - p. 332 135. INTRODUCTION - p. 335 136. METHODOLOGY - p. 335 137. FINDINGS - p. 336 138. DISCUSSION - p. 351 139. CONCLUSION - p. 353 140. INTRODUCTION - p. 354 141. METHODOLOGY - p. 355 142. FINDINGS - p. 357 143. DISCUSSION - p. 360 144. CONCLUSION - p. 363 145. CHAPTER 13: Nephroureterectomy - p. 364 146. CRITICAL ELEMENTS - p. 364 147. 1. REMOVAL OF KIDNEY AND URETER - p. 364 148. 2. MANAGEMENT OF THE DISTAL URETER/CUFF - p. 368 149. 3. LYMPHADENECTOMY FOR UPPER TRACT UROTHELIAL CANCER DURING DEFINITIVE RESECTION - p. 371 150. 4. PERIOPERATIVE INSTILLATION OF INTRAVESICAL CHEMOTHERAPY - p. 375 151. Synoptic Operative Report: TURBT - p. 392 152. Synoptic Operative Report: Radical Cystectomy - p. 395 153. Synoptic Operative Report: Nephroureterectomy - p. 399 154. Synoptic Operative Report: Partial Cystectomy - p. 404 155. COMMENTARY: UROTHELIAL CANCER - p. 409 156. SECTION VI. HEPATOBILIARY - p. 413 157. INTRODUCTION - p. 413 158. CLINICAL STAGING - p. 414 159. MULTIDISCIPLINARY CARE - p. 419 160. PERIOPERATIVE CARE - p. 422 161. QUALITY MEASURES - p. 424 162. CHAPTER 14: Liver Resection for Colorectal Liver Metastases - p. 426 163. CRITICAL ELEMENTS - p. 426 164. 1. Systematic Abdominal Inspection and Intraoperative Ultrasound - p. 426 165. 2. Resection of Planned Lesions to Macroscopically Negative Margins - p. 430 166. CHAPTER 15: Liver Resection for Hepatocellular Carcinoma - p. 433 167. CRITICAL ELEMENTS - p. 433 168. 1. Laparoscopic or Open Inspection of the Abdomen and Liver - p. 433 169. 2. All Lesions Should be Resected to Macroscopically Negative Margins - p. 436 170. CHAPTER 16: Cholangiocarcinoma - p. 440 171. CRITICAL ELEMENTS - p. 440 172. 1. Resection of Primary Tumor to Microscopically Negative Margins - p. 440 173. 2. Routine Portal Lymphadenectomy With Selective Sampling of Aortocaval and Retroperitoneal Nodes - p. 444 174. INTRODUCTION - p. 450 175. METHODOLOGY - p. 450 176. FINDINGS - p. 452 177. CONCLUSION - p. 456 178. INTRODUCTION - p. 457 179. METHODOLOGY - p. 458 180. FINDINGS - p. 458 181. CONCLUSION - p. 462 182. CHAPTER 17: Gallbladder Cancer - p. 463 183. CRITICAL ELEMENTS - p. 463 184. 1. Selective Staging Laparoscopy Prior to Resection of Gallbladder Cancer - p. 463 185. 2. Microscopically Complete (R0) Resection of Local Tumor - p. 466 186. 3. Routine Portal Lymphadenectomy, with Selective Sampling of Aortocaval and Retroperitoneal Nodes - p. 469 187. 4. Port Site Excision Need Not be Performed Routinely for Incidentally Discovered Gallbladder Cancer - p. 471 188. Synoptic Operative Report: Gallbladder Cancer - p. 484 189. Synoptic Operative Report: Hepatocellular Carcinoma - p. 485 190. Synoptic Operative Report: Hilar Cholangiocarcinoma - p. 486 191. Synoptic Operative Report: Intrahepatic Cholangiocarcinoma - p. 487 192. Synoptic Operative Report: Metastatic Colon Cancer - p. 489 193. COMMENTARY: HEPATOBILIARY SECTION - p. 491 194. Index - p. 497
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The Operative Standards for Cancer Surgery manuals provide evidence-based recommendations for the proper technical conduct of cancer surgery. Presented by the American College of Surgeons, Operative Standards for Cancer Surgery: Sarcoma, Adrenal, Neuroendocrine, Peritoneal Malignancies, Urothelial, Hepatobiliary helps surgeons distill the latest evidence into best practices and techniques that lead to improved outcomes. Focused on the steps between skin incision and skin closure, this manual is an invaluable resource for surgical oncologists and general surgeons alike.
1. INTRODUCTION - p. 1 2. CLINICAL STAGING - p. 2 3. MULTIDISCIPLINARY CARE - p. 9 4. PERIOPERATIVE CARE - p. 11 5. QUALITY MEASURES - p. 13 6. CHAPTER 1: Resection of Extremity and Trunk Soft Tissue Sarcoma - p. 14 7. CRITICAL ELEMENTS - p. 14 8. 1. PRETREATMENT BIOPSY OF SOFT TISSUE MASSES OF THE EXTREMITY AND TRUNK - p. 14 9. 2. MACROSCOPICALLY COMPLETE RESECTION OF THE PRIMARY TUMOR - p. 17 10. 3. PLACEMENT OF SURGICAL DRAINS - p. 26 11. INTRODUCTION - p. 28 12. METHODOLOGY - p. 28 13. FINDINGS - p. 30 14. CONCLUSION - p. 39 15. CHAPTER 2: Resection of Retroperitoneal and Intra-Abdominal Soft Tissue Sarcoma - p. 40 16. CRITICAL ELEMENTS - p. 40 17. 1. MACROSCOPICALLY COMPLETE RESECTION OF PRIMARY TUMOR WITHOUT DISRUPTION OF TUMOR CAPSULE - p. 40 18. 2. EN BLOC RESECTION OF INVADED ORGANS TO OBTAIN A COMPLETE GROSS RESECTION - p. 42 19. INTRODUCTION - p. 48 20. METHODOLOGY - p. 48 21. FINDINGS - p. 50 22. CONCLUSION - p. 61 23. Synoptic Operative Report: Extremity Sarcoma - p. 68 24. Synoptic Operative Report: Retroperitoneal Sarcoma - p. 68 25. COMMENTARY: SARCOMA SECTION - p. 71 26. SECTION II. ADRENAL - p. 73 27. INTRODUCTION - p. 73 28. CLINICAL STAGING - p. 74 29. MULTIDISCIPLINARY CARE - p. 75 30. PERIOPERATIVE CARE - p. 76 31. QUALITY MEASURES - p. 82 32. CHAPTER 3: Adrenalectomy Including Multivisceral Resection - p. 83 33. CRITICAL ELEMENTS - p. 83 34. 1. RESECTION OF THE PRIMARY TUMOR TO MICROSCOPICALLY NEGATIVE MARGINS WITHOUT DISRUPTION OF THE TUMOR CAPSULE - p. 83 35. 2. EN BLOC RESECTION OF ADJACENT ORGANS DIRECTLY INVADED BY CANCER - p. 88 36. INTRODUCTION - p. 91 37. METHODOLOGY - p. 91 38. FINDINGS - p. 98 39. CONCLUSION - p. 102 40. CHAPTER 4: Vascular Invasion - p. 103 41. CRITICAL ELEMENTS - p. 103 42. 1. EN BLOC RESECTION OF ADJACENT BLOOD VESSELS DIRECTLY INVOLVED BY PRIMARY TUMOR AND/OR TUMOR THROMBUS - p. 103 43. INTRODUCTION - p. 110 44. METHODOLOGY - p. 110 45. FINDINGS - p. 112 46. CONCLUSION - p. 114 47. CHAPTER 5: Lymphadenectomy - p. 116 48. CRITICAL ELEMENTS - p. 116 49. 1. RESECTION OF REGIONAL LYMPH NODES INVOLVED BY METASTATIC ADRENAL CANCER - p. 116 50. INTRODUCTION - p. 120 51. METHODOLOGY - p. 120 52. FINDINGS - p. 126 53. CONCLUSION - p. 128 54. Synoptic Operative Report: Adrenal - p. 135 55. COMMENTARY: ADRENAL SECTION - p. 141 56. SECTION III. NEUROENDOCRINE - p. 143 57. INTRODUCTION - p. 143 58. CLINICAL STAGING - p. 147 59. MULTIDISCIPLINARY CARE - p. 147 60. PERIOPERATIVE CARE - p. 154 61. QUALITY MEASURES - p. 154 62. CHAPTER 6: Small Bowel Resection - p. 156 63. CRITICAL ELEMENTS - p. 156 64. 1. INTRAOPERATIVE EVALUATION AND IDENTIFICATION OF PRIMARY TUMOR(S) - p. 156 65. 2. REGIONAL LYMPHADENECTOMY ALONG SEGMENTAL VESSELS - p. 160 66. 3. RESECTION OF THE PRIMARY TUMOR - p. 164 67. INTRODUCTION - p. 166 68. METHODOLOGY - p. 166 69. FINDINGS - p. 167 70. CONCLUSION - p. 173 71. INTRODUCTION - p. 174 72. METHODOLOGY - p. 175 73. FINDINGS - p. 175 74. CONCLUSION - p. 178 75. CHAPTER 7: Parenchyma-Preserving Pancreatectomy - p. 179 76. CRITICAL ELEMENTS - p. 179 77. 1. INTRAOPERATIVE ULTRASOUND PRIOR TO ENUCLEATION - p. 179 78. 2. RESECTION OF THE PRIMARY TUMOR - p. 180 79. 3. REGIONAL LYMPH NODE SAMPLING OF THE PERIPANCREATIC AND CELIAC LYMPH NODES - p. 183 80. INTRODUCTION - p. 185 81. METHODOLOGY - p. 185 82. FINDINGS - p. 187 83. CONCLUSION - p. 198 84. Synoptic Operative Report: Pancreatic Neuroendocrine Tumor - p. 209 85. Synoptic Operative Report: Small Bowel Neuroendocrine Tumor - p. 209 86. COMMENTARY: NEUROENDOCRINE SECTION - p. 211 87. SECTION IV. PERITONEAL MALIGNANCIES - p. 215 88. INTRODUCTION - p. 215 89. CLINICAL STAGING - p. 216 90. MULTIDISCIPLINARY CARE - p. 219 91. PERIOPERATIVE CARE - p. 219 92. QUALITY MEASURES - p. 221 93. CHAPTER 8: Cytoreduction - p. 223 94. CRITICAL ELEMENTS - p. 223 95. 1. SUPRACOLIC GREATER OMENTECTOMY - p. 223 96. 2. RESECTION OF MESENTERIC DISEASE - p. 227 97. 3. CYTOREDUCTION OF THE DIAPHRAGM - p. 228 98. 4. CYTOREDUCTION WITHIN THE PELVIS - p. 233 99. 5. ABDOMINAL VISCERAL RESECTIONS - p. 239 100. CHAPTER 9: Drug Delivery and Safety - p. 249 101. CRITICAL ELEMENTS - p. 249 102. 1. HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY FOLLOWING CYTOREDUCTION - p. 249 103. INTRODUCTION - p. 254 104. METHODOLOGY - p. 255 105. FINDINGS - p. 256 106. CONCLUSION - p. 268 107. INTRODUCTION - p. 269 108. METHODOLOGY - p. 269 109. FINDINGS - p. 271 110. CONCLUSION - p. 273 111. Synoptic Operative Report: Peritoneal - p. 283 112. COMMENTARY: PERITONEAL SECTION - p. 286 113. SECTION V. UROTHELIAL - p. 290 114. INTRODUCTION - p. 291 115. CLINICAL STAGING - p. 292 116. MULTIDISCIPLINARY CARE - p. 294 117. PERIOPERATIVE CARE - p. 301 118. QUALITY MEASURES - p. 302 119. CHAPTER 10: Endoscopic Management - p. 303 120. CRITICAL ELEMENTS - p. 303 121. 1. ENDOSCOPIC EVALUATION OF URETHRA AND BLADDER - p. 303 122. 2. TRANSURETHRAL RESECTION OF BLADDER TUMOR - p. 306 123. 3. ENDOSCOPIC EVALUATION AND TREATMENT OF UPPER TRACT DISEASE - p. 308 124. 4. POSTOPERATIVE INSTILLATION OF INTRAVESICAL CHEMOTHERAPY - p. 311 125. CHAPTER 11: Partial Cystectomy - p. 313 126. CRITICAL ELEMENTS - p. 313 127. 1. INTRAOPERATIVE LOCALIZATION OF TUMOR - p. 313 128. 2. RESECTION TO ADEQUATE MARGINS - p. 315 129. CHAPTER 12: Radical Cystectomy - p. 319 130. CRITICAL ELEMENTS - p. 319 131. 1. REMOVAL OF BLADDER TO NEGATIVE RESECTION MARGINS - p. 319 132. 2. CONCOMITANT PELVIC ORGAN MANAGEMENT IN MEN AND WOMEN - p. 323 133. 3. PELVIC LYMPH NODE DISSECTION - p. 329 134. 4. SELECTION OF A URINARY DIVERSION PROCEDURE - p. 332 135. INTRODUCTION - p. 335 136. METHODOLOGY - p. 335 137. FINDINGS - p. 336 138. DISCUSSION - p. 351 139. CONCLUSION - p. 353 140. INTRODUCTION - p. 354 141. METHODOLOGY - p. 355 142. FINDINGS - p. 357 143. DISCUSSION - p. 360 144. CONCLUSION - p. 363 145. CHAPTER 13: Nephroureterectomy - p. 364 146. CRITICAL ELEMENTS - p. 364 147. 1. REMOVAL OF KIDNEY AND URETER - p. 364 148. 2. MANAGEMENT OF THE DISTAL URETER/CUFF - p. 368 149. 3. LYMPHADENECTOMY FOR UPPER TRACT UROTHELIAL CANCER DURING DEFINITIVE RESECTION - p. 371 150. 4. PERIOPERATIVE INSTILLATION OF INTRAVESICAL CHEMOTHERAPY - p. 375 151. Synoptic Operative Report: TURBT - p. 392 152. Synoptic Operative Report: Radical Cystectomy - p. 395 153. Synoptic Operative Report: Nephroureterectomy - p. 399 154. Synoptic Operative Report: Partial Cystectomy - p. 404 155. COMMENTARY: UROTHELIAL CANCER - p. 409 156. SECTION VI. HEPATOBILIARY - p. 413 157. INTRODUCTION - p. 413 158. CLINICAL STAGING - p. 414 159. MULTIDISCIPLINARY CARE - p. 419 160. PERIOPERATIVE CARE - p. 422 161. QUALITY MEASURES - p. 424 162. CHAPTER 14: Liver Resection for Colorectal Liver Metastases - p. 426 163. CRITICAL ELEMENTS - p. 426 164. 1. Systematic Abdominal Inspection and Intraoperative Ultrasound - p. 426 165. 2. Resection of Planned Lesions to Macroscopically Negative Margins - p. 430 166. CHAPTER 15: Liver Resection for Hepatocellular Carcinoma - p. 433 167. CRITICAL ELEMENTS - p. 433 168. 1. Laparoscopic or Open Inspection of the Abdomen and Liver - p. 433 169. 2. All Lesions Should be Resected to Macroscopically Negative Margins - p. 436 170. CHAPTER 16: Cholangiocarcinoma - p. 440 171. CRITICAL ELEMENTS - p. 440 172. 1. Resection of Primary Tumor to Microscopically Negative Margins - p. 440 173. 2. Routine Portal Lymphadenectomy With Selective Sampling of Aortocaval and Retroperitoneal Nodes - p. 444 174. INTRODUCTION - p. 450 175. METHODOLOGY - p. 450 176. FINDINGS - p. 452 177. CONCLUSION - p. 456 178. INTRODUCTION - p. 457 179. METHODOLOGY - p. 458 180. FINDINGS - p. 458 181. CONCLUSION - p. 462 182. CHAPTER 17: Gallbladder Cancer - p. 463 183. CRITICAL ELEMENTS - p. 463 184. 1. Selective Staging Laparoscopy Prior to Resection of Gallbladder Cancer - p. 463 185. 2. Microscopically Complete (R0) Resection of Local Tumor - p. 466 186. 3. Routine Portal Lymphadenectomy, with Selective Sampling of Aortocaval and Retroperitoneal Nodes - p. 469 187. 4. Port Site Excision Need Not be Performed Routinely for Incidentally Discovered Gallbladder Cancer - p. 471 188. Synoptic Operative Report: Gallbladder Cancer - p. 484 189. Synoptic Operative Report: Hepatocellular Carcinoma - p. 485 190. Synoptic Operative Report: Hilar Cholangiocarcinoma - p. 486 191. Synoptic Operative Report: Intrahepatic Cholangiocarcinoma - p. 487 192. Synoptic Operative Report: Metastatic Colon Cancer - p. 489 193. COMMENTARY: HEPATOBILIARY SECTION - p. 491 194. Index - p. 497
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