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Comprehensive Clinical Hepatology.
  1. D H ADAMS

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Comprehensive Clinical Hepatology. Edited by JG O'Grady, JR Lake, PD Howdell (illustrated; £129.00). UK: Harcourt Publishers, 2000. ISBN 0-7234-3106-X.

The rapid and exciting developments in hepatology in recent years make an innovative and comprehensive textbook of clinical hepatology very welcome. The editors, who are themselves international authorities in the field, have assembled an impressive array of multinational hepatological talent to compile their comprehensive textbook of clinical hepatology. It is a pleasure to read a textbook where each of the chapters is written by an authority in the field. One problem of such multiauthor books can be the often jarring changes in style between different contributors, but the editors of this book are to be congratulated in assimilating a diverse group of writers and editing their work into a uniform and very readable style. The other aspect of this book, which impresses you immediately, is the clarity of the presentation, particularly the figures. The book is beautifully laid out and the figures are superb. If the publishers made these figures available on a CD-ROM, I am sure that all of us who lecture on liver disease would snap them up immediately. The surgical chapters are particularly impressive, not only for the quality of the figures and the straightforward explanation of the techniques, but also because they have been included in a textbook of hepatology. This is evidence of the multidisciplinary approach, which is such an important part of treating patients with liver disease. Given the interest of the editors it is not surprising that liver transplantation is given the prominence it deserves in a textbook of hepatology and the subject is covered comprehensively from surgical techniques and patient selection through to the excellent chapter from Geoff McCaughan on immunology and immunosuppression. Other highlights include the superb chapter by Fan and Steer on cell biology, where again the quality of the illustrations makes it a pleasure as well as an education to read, and a welcome chapter on the liver in the critically ill, a common but often neglected clinical problem.

So are there any criticisms? I have a few complaints about areas that in my opinion have been neglected. The chapters are organised by individual diseases, which means that some of the more general processes are not covered in full. For instance, it would have added to the book to have a chapter on fibrogenesis and the development of cirrhosis; two other areas that probably warrant a chapter of their own are radiology, particularly with the increasing capabilities of interventional radiologists, and the role and interpretation of liver biopsy. As far as clinical areas are concerned, I could find no mention of liver disease in bone marrow transplantation, a difficult area which would benefit from being covered in a book such as this. A minor quibble is the indexing which I would revise for the next addition. There are several omissions; for example, benign intrahepatic cholestasis and veno-occlusive disease are both discussed in the text but not listed in the index and I personally do not like the idea of paginating in sections and chapters. With a book of this length it is surely easier to simply number the pages. However, these are minor complaints and on the whole I would recommend this book to anyone interested in liver disease and particularly to trainees in gastroenterology, hepatology, or hepatobiliary surgery who will come back to this book again and again.