Diseases of the Liver and Biliary System

Diseases of the Liver and Biliary System

April 1998 Harald Henning, and Kurt Beck, all of whom made major contributions through their lectures, medical writing, and superb photographic docum...

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April 1998

Harald Henning, and Kurt Beck, all of whom made major contributions through their lectures, medical writing, and superb photographic documentation abilities. Henning and Beck, as well as Giorgio Dagnini of Italy, published superb atlases of diagnostic endoscopy. This text’s orientation naturally favors the recent, more exciting developments in therapeutic laparoscopy. It contains numerous color snapshots and formal photographs that strengthen the narrative and add a personal touch. The author has succeeded in providing us with one of the most thorough personal and historical accounts available of any diagnostic or therapeutic technique. He has the novelist’s unique ability to integrate world history, politics, social attitudes and constraints, personalities, professional conflicts, and acts of productive cooperation among practitioners and academicians. Bottom Line: Any physician or surgeon who performs or has an interest in either diagnostic or therapeutic laparoscopy or medical history will surely enjoy this work. It is recommended highly for reading and for the library shelf as a reference. H. WORTH BOYCE, M.D. Division of Digestive Diseases and Nutrition University of South Florida College of Medicine Tampa, Florida

Diseases of the Liver and Biliary System. By Sheila Sherlock and James Dooley. 714 pp. $150.00. Blackwell Science, Oxford, England, 1997. ISBN 0-86542-906-5. This year brings us the occasion of the tenth edition of Sherlock and Dooley’s Diseases of the Liver and Biliary System. The authors of this ‘‘warhorse’’ textbook have strived to integrate the dizzying expansion of knowledge in liver disease over the 4 years since the ninth edition into a format that is, above all, accessible to students, residents, fellows, and generalists. To this end, they have grandly succeeded. The new edition has added more than 1000 new references, 100 new figures, and greatly expanded coverage of the viral hepatitides, liver transplantation, newer interventions for portal hypertension, along with consideration of the discoveries of the genetic basis for hemochromatosis and Wilson’s disease. Incorporation of these and other new developments is accomplished without the need to move into a two-volume set or a bulky single volume. Indeed, this edition is printed with no significant change in length from its predecessor. This fact is attributable in great measure to the deliberately laconic style of the authors that has by now become a familiar hallmark of their work. First-time readers of this textbook should understand that the highly declarative statements that characterize the text are distillations of the authors’ extensive clinical experience and do not attempt to capture the discourse and debate that surround several of the key concepts in liver disease. Put another way, this is not a text for those who seek a comprehensive reference. The organization of the book is for the most part straightfor-

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ward and logical, beginning in its first third with consideration of key pathophysiological processes, followed by a more detailed probing of individual disease entities. The chapter on viral hepatitis is lucid and relevant and includes discussion of the clinical significance of hepatitis B virus mutants as well as discovery of the GBV-C or hepatitis G viral agent. The latter, perhaps, does not warrant the nearly full page that it receives. The only unfortunate chapter division that leaves the reader searching for continuity occurs when the authors separate chronic viral hepatitis and its treatment (including it in a separate chapter on chronic hepatitis) from the chapter on viral hepatitis, which covers the viruses and their more acute manifestations. Nonetheless, the coverage of antiviral therapy is appropriate and current, even discussing the role of combined use of interferon and ribavirin in the management of chronic hepatitis C infection. In an area such as antiviral treatment already congested with seemingly obfuscatory literature, the authors’ succinct style of synthesis is especially refreshing. Other subjects treated with particular clarity include portal hypertension, alcoholic liver disease, primary biliary cirrhosis, nutritional and metabolic liver diseases, and hepatic tumors. The section on liver transplantation deserves special mention for its illumination of both technical aspects of transplant surgery and posttransplant graft complications. As with previous editions (and even more so with this one), the figures and tables are extraordinarily helpful. The color plates are often breathtaking. Schematics of hepatic anatomy, along with simplified algorithms for disease management, are presented clearly and are easy to read. The tables are almost always uncluttered and benefit from parsimony of space. It is clear that great pains were taken to ensure presentability and a basic message at the cost of often unnecessary detail. There are areas where the text could have benefited from more careful editing. For example, among the predisposing factors to Budd–Chiari syndrome is the factor V (rather than factor IV) Leiden mutation. However, these oversights do not significantly detract from accomplishment of the overall mission of the book. This text will not be the first choice for those seeking to understand more fully the basis of individual diseases of the liver. It will, however, be the reference of choice for those who wish to survey subjects in a manner that delivers the bottom line on these diseases. It is sufficiently well-referenced for the reader to seek out the classics in the field. Bottom Line: More than any other text in liver disease, this one provides the best source of synthesized clinical wisdom, a currency in ever increasingly short supply as our fund of factual knowledge burgeons. Indeed, if one demanded that an author confine the breadth of our existing knowledge in liver disease into a readable clinical textbook of less than 700 pages, he or she could do no better than to direct that individual to Sherlock and Dooley’s Diseases of the Liver and Biliary System. RAYMOND T. CHUNG, M.D. Gastrointestinal Unit Massachusetts General Hospital Boston, Massachusetts