經典著作 半個多世紀以來,《Zollinger外科手術圖譜》已經成為學習如何將安全、成熟的技術應用於蕞常見的外科手術中的經典圖譜。
內容全麵 本圖譜包括胃腸、肝膽、胰、血管、婦産科及其他方麵的手術,如疝修補、血管通路、乳房手術、前哨淋巴結活檢術、甲狀腺切除術等。每種手術從適應證、術前準備、麻醉、體位、手術準備、切口和暴露、手術過程、縫閤和術後護理等方麵予以介紹。第10版新增瞭19個手術內容。
圖片精美 每章包含精美細緻的綫條圖,描述手術操作中的重要步驟時,用顔色突顯相應的解剖位置。觀看本書提供的解剖和手術操作圖片,有助於復習和學習特定的手術步驟。
《Zollinger外科手術圖譜》自1937年第1版至今已達第10版,暢銷全球,深受各界讀者歡迎。內容包括手術技術、手術部位局部解剖、麻醉、術前術後處理和輔助治療(如抗感染)等。手術學科涉及普外科(胃腸道、肛周部、肝膽胰脾、頸部、乳房、疝、腎上腺、盆腔)、婦科、血管外科、骨科等。手術技術包括直接開放手術和腔鏡微創手術,也涉及截肢和皮膚移植。既對高級外科醫師有指導、參考、交流、提高的作用,更可幫助中青年外科醫師、各級研究生和各類進修醫師打好堅實的外科學基礎,提升實際應用的能力。
Robert M. Zollinger,是美國凱斯西儲大學(Case Western Reserve University)醫學院外科教授,是世界知名的外科專傢。
Preface
Associate Editors
section i: basics
section ii: surgical anatomy
section iii: general abdomen
section iv: esophagus and stomach
section v: small intestine, colon,and rectum
section vi: gall bladder, bileducts, and liver
section vii: pancreas and spleen
section Viii: genitourinary
section ix: hernia
section x: endocrine
section xi: head and neck
section xii: skin, soft tissue, and breast
section xiii: vascular
section xiv: extremities
Some 75 years ago, this ATLAS was created to document proven and safe operative techniques in common use by general surgeons. Many improvements and changes have occurred in the previous nine editions including use of stapled techniques for gastrointestinal anastomoses and minimally invasive surgery. These two techniques were joined in full flower in the ninth edition wherein what was once considered advanced laparoscopic techniques in the 1990s is now in common use and taught as essential elements in most surgical residency training programs.
In this new 10th edition several important improvements have been made. We have engaged Associate Editors as content experts who have helped identify new procedures that should be included and who have made significant improvements to existing content. Nineteen new surgi- cal operations have been added. These include eight procedures that we think are essential to the practice of general surgery including axillary lymphadenectomy, insertion of a CAPD catheter, fasciotomy, escharotomy, insertion of an inferior vena caval filter, ventral hernia repair using the technique of open component parts separation, ureter repair, and basic thoracoscopy. In addi- tion we have included four additional complex gastrointestinal procedures namely laparoscopic esophageal myotomy, sleeve gastrectomy for morbid obesity, transhiatalesophagectomy and transthoracic esophagectomy. The vascular surgery section now contains new variations on femo- ralthrombectomy, femorofemoral bypass, saphenous vein laser ablation, and thrombectomy of the superior mesenteric artery. Finally we added laparoscopic hand-assisted donor nephrectomy and kidney transplantation.
A major editorial reorganization has also occurred with the addition of 18 Associate Editors whose special expertise has been channeled into discrete body system–oriented chapters. This reor- ganization should make it easier to find operations whose titles no longer use roman numerals. The authors and the associate editors have critically reviewed and updated this entire 10th edition. The scientific content of all operative procedures from indications through postoperative care have been made current with significant improvements in about 50 chapters of text and art.
During the preparation of the 10th edition we received valuable input from Brian Belval at McGraw Hill and Donna Sampsill in the Department of Surgery at The Ohio State University. In the ninth edition, color processing and printing technology had advanced such that our medical illus- trators, could add color to both old and new plates for improved anatomic clarity in more lifelike or realistic settings. For this 10th edition our medical illustrator, MaritaBitans, has prepared new art- work plates in high definition color with computer-generated graphics that now replace the original pen and ink sketches using white chalk scratch board.
We have also created an online Historical Supplement available at www.ZollingersAtlas.com to provide open access to many now historical operations that over the last 70 years have been deleted from succeeding editions of the ATLAS. Many were replaced by newer procedures often involving modern technologies such as stapling, laparoscopy, or minimally invasive image-guided procedures. Others were rarely performed and a few were eliminated because of evolving indications. Addition- ally, in the past the authors and artists had page limitations imposed by the mechanical construction of the folio-sized ATLAS and the capacity of its binding. That is to say, heavily coated paper stock was needed for quality art reproduction and for the prevention of “strike through” of printed material on the backside of each page. The result was a restriction to about 500 pages—a size reached by the mid-1980s. At that point, the addition of any new or modern procedures such as stapling or laparos- copy required the pruning out of operations that (1) were rarely done—for example, portal/systemic shunts, or (2) were done by the increasing numbers of surgical specialists—for example, thoracic/ pulmonary operations.
Furthermore, the authors and the publisher feel that many once popular operations should not be lost, but rather archived in this electronic Historical Supplement of the ATLAS where there are no page limitations. Many of these archived operations are still performed in specialized or com- plex situations because general surgeons by the nature of their practice, not infrequently encounter one of a kind events that are not in the text books. In these circumstances the surgeon must create an operative solution in real time. These solutions often rely upon general principles and expe- rience, perhaps aided by one of these “old” operations. This may be particularly true in regions where expensive operative equipment such as staplers or disposable laparoscopic instruments are not available.
Today many medical libraries cannot afford to purchase and store all published texts, or even all the major printed medical journals. However, the internet is truly worldwide and accessible to almost all medical/surgical facilities and physicians. We trust this electronic Historical Supplement will help fill in some of the historical surgical technique reference gaps.
As Dr. Cutler graciously allowed his original coauthor to continue on after him, so my father did with me. Now it is my turn. Dr. E. Christopher Ellison has become the new lead principle author who will continue the ATLAS. Dr. Ellison is the other son of the Z-E syndrome. He is the RobertM. Zollinger Professor in the Department of Surgery at the Ohio State University Medical Center. He has accepted the primary responsibility for the ATLAS and its migration back to Columbus and the OSU Department of Surgery, where Dr. Zollinger Senior nurtured the ATLAS for over 40 years. Finally, of additional historic note, all of Dr. Zollinger’s papers plus the text and artwork from all earlier editions are now archived in the Medical Heritage Center within the OSU Prior Health Sciences Library where these materials are catalogued and available online.
E. Christopher Ellison, MD
Robert M. Zollinger, Jr., MD
我是一名資深的外科醫生,在多年的臨床實踐中,我接觸過各種各樣的手術圖譜和教科書,《Zollinger's Atlas of Surgical Operations》的第10版英文版,給我留下瞭深刻的印象。盡管我已經是一名經驗豐富的醫生,但知識的更新換代是永恒的課題,尤其是在手術技術飛速發展的今天。這本書的齣版,意味著它匯集瞭最新的外科理念和技術,這一點對於保持我的專業前沿性至關重要。我特彆欣賞它對細節的把控,那些精細的解剖層次、神經血管的走嚮、以及關鍵的止血點,都被描繪得淋灕盡緻,這對於規避手術風險、提高手術精準度有著不可替代的作用。我更傾嚮於通過視覺化的方式來迴顧和學習新的手術技術,而不是單純地依賴文字描述,而這本書恰恰提供瞭我所需要的。我相信,即使是經驗豐富的外科醫生,也能從中汲取新的靈感,發現自己知識體係中的一些盲點,並不斷優化自己的手術技巧。這本書不僅僅是年輕醫生的入門指南,更是資深外科醫生不斷精進的良師益友。
评分最近,我收到瞭《Zollinger's Atlas of Surgical Operations》第10版英文版,這本書的封麵設計就給我一種專業、嚴謹的感覺,打開書頁更是驚喜連連。雖然我不是外科醫生,但我對醫學,尤其是外科手術有著濃厚的興趣,而這本書簡直是為我這樣的愛好者量身定做的。我最喜歡的部分是那些高質量的插圖,它們不僅僅是簡單的示意圖,而是非常寫實地展現瞭人體的解剖結構和手術過程中的關鍵步驟。我經常會花很長時間去欣賞這些插圖,嘗試理解每一個手術的邏輯和精妙之處。這本書的語言風格也很適閤我,雖然是英文版,但配閤著豐富的視覺信息,很多概念都能夠被我這個非專業人士理解。我經常會把這本書當作一本“科普讀物”來翻閱,從中瞭解不同疾病的外科治療方法,以及外科醫生在手術中需要考慮的各種因素。它讓我對外科手術有瞭更深刻的認識,也讓我對那些在手術颱上默默奉獻的醫生們充滿瞭敬意。
评分我最近入手瞭《Zollinger's Atlas of Surgical Operations》的第10版英文原版,這本書簡直是外科手術愛好者的寶藏!雖然我還沒有深入研究其中的具體手術操作,但僅僅是翻閱目錄和大緻瀏覽一下圖譜的質量,就足以讓我激動不已。那些精美的插圖,細節豐富到令人驚嘆,每一頁都像是藝術品,又充滿瞭嚴謹的科學性。我特彆欣賞它的編排方式,每一章都清晰地劃分瞭不同的外科領域,從腹部到胸腔,再到骨科和神經外科,似乎囊括瞭大部分常見和重要的手術。我尤其對那些能夠直觀展示解剖結構和手術路徑的插圖充滿期待,相信它們能幫助我更好地理解那些復雜的手術過程。這本書厚重而紮實,拿在手裏就有一種沉甸甸的專業感,讓我對接下來的學習充滿瞭信心。我計劃花大量的時間來消化其中的內容,尤其是那些對於初學者來說可能比較難以理解的概念,我希望能通過這些圖譜得到直觀的、清晰的解釋。這本書不僅僅是一本教材,更像是一本打開外科手術世界大門的鑰匙,充滿瞭探索的樂趣。
评分入手《Zollinger's Atlas of Surgical Operations》第10版英文版,對我而言,不僅僅是獲得瞭一本新的醫學書籍,更像是擁有瞭一位經驗豐富的手術嚮導。這本書的重量和厚度,預示著它內容的豐富程度,而當我真正翻開它時,我被其精美的印刷質量和清晰的插圖所震撼。我尤其喜歡它對每一項手術的介紹,雖然我還沒有深入學習每一個細節,但那種條理清晰的結構,讓我能夠很快地把握一個手術的大緻輪廓。我設想,在未來實際學習和操作中,這本書將成為我最得力的助手,它能夠幫助我可視化復雜的手術步驟,理解關鍵的解剖結構,甚至預測可能齣現的睏難。我是一個注重細節的人,而這本書恰恰滿足瞭我對精益求精的追求。它的存在,讓我對未來的學習充滿瞭期待,仿佛打開瞭一個充滿知識和挑戰的新世界。這本書不僅僅是一份技術手冊,更是一種對外科藝術的緻敬,它激勵著我去探索、去學習、去成為一名更優秀的外科醫生。
评分作為一名即將踏入臨床的外科實習醫生,我一直在尋找一本能夠幫助我建立紮實外科基礎的工具書,《Zollinger's Atlas of Surgical Operations》第10版英文版無疑滿足瞭我的需求。這本書的權威性毋庸置疑,它所涵蓋的知識體係非常全麵,從經典的開放手術到一些新興的微創技術,都有所涉及。我尤其看重它的視覺呈現方式,那些高清、逼真的插圖,對於我們這些需要將理論知識轉化為實際操作的醫學生來說,其價值是無可估量的。我曾經嘗試閱讀過一些純文字描述的手術步驟,但往往難以形成清晰的畫麵感,而這本書則恰恰解決瞭我的痛點。我期待通過研讀這本書,能夠更深入地理解每一颱手術的適應癥、禁忌癥、術前準備、術中關鍵步驟以及術後並發癥的防治,這些都是決定手術成功與否的關鍵因素。這本書的齣版曆史悠久,並且不斷更新,證明瞭它在外科界的地位和實用性,我迫不及待地想在臨床實踐中運用這本書所提供的知識和指導,讓自己的外科之路更加穩健。
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