Br. J. Surg. Vol. 66 (1979) 371-372

Book reviews Surgery of the Pancreas: a Text and Atlas Edited A. M. Cooperman. 280x215 mm. P p , 257fx i0 , with 273 illustrations. 1978. London: Kimpton. €35.70. T H l s is an interesting volume, the authors having set out to produce a text and atlas of pancreatic disease for the practising clinical surgeon and surgical resident. The text is commendably brief and the illustrations clear and concise. I especially liked the brief concluding sections of personal observations and preferences which accompany some chapters. Somewhat less satisfactory is the approach to diagnosis which, while outlining in a capable manner the modern diagnostic techniquesavailable, fails to arrange them in an order of priority and give them an overall evaluation. There is little cross-reference between the various diagnostic techniques mentioned and missingfrom this section of the book is the argued personal approach so evident in the section on operative management. The relationshjp of particular diagnostic techniques to surgical approaches and to operability is not well covered and the advantages and dis- advantages of intraoperative diagnostic techniques are not sufficiently underlined.

There is a full discussion of contentious issues, such as the value of intraoperative biopsy of the pancreas and the operative treatment of acute pancreatitis. The section on pseudocyst is well presented but perhaps reveals an under-appreciation of the value of information to be gained from preoperative ultrasonic examination. The coverage of chronic pancreatitis is adequate for the average surgeon but perhaps somewhat brief for the specialist in the field, the real difficulties such as the necessity for total pancreatectomy and the niceties of the operation of subtotal pancreatectomy being dealt with somewhat sketchily. By contrast, there is a large section on thoracic splanchnicec- tomy and sympathectomy for relief of pancreatic pain despite the apt comment that the procedure seldom gives long term relief.

The discussion on cancer of the pancreas and periampullary region is comprehensive. Adequate mention is made of the use of diagnostic tests and the advisability of two-stage operation in some situations where the bilirubin level is high and renal function compromised. There is perhaps less comment than one would like to see on the recent, more frequent use of total pancreatic resection for pancreatic cancer and recent advances in this area require fuller discussion. The operation of pancreaticoduodenectomy is described at length and well illustrated, but again there is little discussion of the dangers and postoperative complications which may result, and a somewhat tedious homage to the views of George Crile jun. in his advocacy of conservative measures.

This book can be recommended for the general surgeon who is faced with an operative problem in pancreatic surgery and is of interest to the specialists.

L. H. BLUMGART

Pathology of Peripheral Nerves Arthur K. Asbury ond Peter C . Johnson. 270 x 185 mm. Pp, 311 f xii. lllustrarrci! 197%. Ensfbourne: Holt-Saunders. €15.00.

THE main aim of this excellently produced and very readable book is to educate general pathologists in a field that is often a mystery to them, and because of thi? orientation it will be a valuable reference book for all who have occasional contact with peripheral nerves. The presentation of modern ideas about peripheral nerves and their disorders simply, concisely and fully makes this book a must for specialists also. Trauma, tumours, metabolic and diabetic neuropathies are general topics covered and there is a useful practical description of the technique of sural nerve biopsy. The quality of the photo- micrographs is outstanding.

PAMELA M. LE OUESNE

A Practice of Anaesthesia Edircd H . C. Chiirchili- Dacidson. 4fh edition. 240 x I60 mm. Pp. 1542+xuiii. Illustrated. 197%. London: Lloyd-Luke. f 2 6 0 0 . THE fourth edition of this standard anaesthetic text will maintain its position on the reading list of every postgraduate student of the subject. This edition has lost one of its founder authorieditors, Dr Wylie, but has increased the number of assistant editors who cover a wide range of special interests.

There are many changes. The assistant editors have completely rewritten some chapters and expanded others, though the book retains its form and clarity of layout. Many of the original illustrations and diagrams are included, which will give the book a ‘familiar’ appearance for those who have used it extensively for reference and examination preparation.

Chapters on pacdiatric anaesthesia, placental transfer and the development of anaesthetic apparatus are included in this volume for the first time. The chapter on paediatric anaesthesia embles the non-specialist postgraduate student to find the basic information assembled in logical order. Dr Reynolds’s excellent chapter on placental transfer of respiratory gases and drugs provides a welcome addition to the text. The outline of the development of anaesthetic apparatus is most interesting to read, with illustrations of these historic pieces o f equipment which many readers may never have had the opportunity to see.

Otherchanges include reference to the role of prostaglandins, a description of che more recent anaesthetic agents, the now commonly used circulatory support drugs and a less detailed but broader description of mechanical ventilation and venti- lators. In keeping with current development, S1 units are inc!uded, but unfortunately only in parentheses.

J. HULF

Guide to House Surgeons in the Surgical Unit G. J. Froenkel, J . Ludbrook and H. A . F. Dudlev. Sixth edition. I S 0 x 120 mni. Pp. 203fx i i . Illustrated. 1978. London: Heinemann. f2.90. THI? is an excellent book filling a gap between university graduation and the fully qualified, registered state through which young doctors have to survive many pitfalls. The main theme of the book is to give the houseman a thorough under- scanding of his role in a modern teaching hospital, without at any time forgetting that the whole aim of the exercise is to provide diagnosis and treatment combined with consideration and kindness for the sick patient. Most housemen will know in theory what should be done, but in practice and in order of preference many investigations require programming. This exercise runs from the personal touch, following up request cards by telephone calls, fulfilling the role of guide, philosopher and friend to patients, and at times that of minor executive in regard to senior colleagues while at the same time listening to advice from all paramedical and nonmedical personnel who, as this book says, ‘by their very permanence have a knowledge and authority which can be most useful if properly exploited!’ The influence of one of its authors can be seen particularly in the flow diagrams for dealing with patients who have, for example, retention of urine, undiagnosed liver disease and postoperative mental dysfunction; this latter flow chart, how- ever, seems to have been photoreduced to fit the page and certainly reminded this reviewer that it is several years since he had the visual acuity of a houseman! Some change of typeset would encourage and help clarity in this figure. That apart, the book is to be warmly and wholeheartedly recom- mended to those embarking on a career as a houseman, for i t is up-to-date, well indexed and full of good counsel from experienced authors. It also fits neatly into a white coat pocket.

J. B. ELDER