From The New England Journal of Medicine

Generally speaking, there are two types of textbooks today. The first, and by far the more frequently published, is the multiauthored textbook, which is usually authoritative but varies in quality and style owing to the number of authors. The second, increasingly rare, is the textbook by one or two authors who present their extensive personal knowledge and experience. This type of book benefits from a uniform style, but it is still a personal account of the subject and a personal appraisal of the literature. In the field of hepatology, we have many examples of the first type, and for the second, we have the classic textbook by the late Dame Sheila Sherlock. In Hepatology: Principles and Practice, Erwin Kuntz and his son, the late Hans-Dieter Kuntz, provide another example of the second type of textbook. The result is a very readable book, written in a terse, economical style, in English of a very high standard, presumably translated from the original German. Hepatology: Principles and Practice has many excellent features. I particularly liked the way the reader is prepared to recognize important statements, which are highlighted in color in italics or preceded by a large, black dot for maximal effect. There is a great deal of information given in table form -- again, highlighted in color. There are many figures. The laparoscopic and ultrasonographic images are excellent, and the liver histology is reproduced amazingly well, as if the reader were there, looking through the microscope. I also enjoyed the authors' insistence on providing the historic, seminal publications on each subject, referenced by name in the text, thereby giving appropriate recognition to their authors and a sense of history to the subject, both of which are all too rare in these days of "state-of-the-art" publications. There are some surprises in this book. One is the emphasis on laparoscopy and laparoscopic biopsy, which are used much more in Europe than in North America. Among some major gaps are a detailed discussion of hepatic stellate cells, a description of the genetic defects associated with the congenital hyperbilirubinemias, and an account of the initial effect of alcohol on the liver. In the chapter on hepatocellular carcinoma, there was no discussion of screening and surveillance; the authors' view of the diagnostic value of alpha-fetoprotein levels seems too enthusiastic; and the discussion of the prognosis of hepatomas uses the tumor-node-metastasis stage, rather than more recently developed clinical prognostic indexes. From the section on portal-vein thrombosis in adults, one does not gain an appreciation of the importance of the inherited thrombophilic states in the pathogenesis. Other problems include the strange mix of the clinical and pathological classifications of liver disease in chapter 21; only passing mention of transjugular intrahepatic portosystemic shunting, known as TIPS; and the failure to include adequate discussion of the handling of renal sodium in patients with ascites. The authors enumerate various therapies fully, but they do not give any sense of priorities or of an algorithmic approach to therapy, and in an effort to be all-inclusive, they mention therapies that have not stood up to the test of evidence-based medicine. I do not believe that any single-authored textbook in a field as vast as hepatology -- with its divergent and rapidly progressing areas, such as molecular biology, biochemistry, virology, and circulatory physiology -- can compete with a multiauthored book by specialists. Even so, I think this textbook on hepatology could be very useful for general internists or "luminal" gastroenterologists, who want to keep abreast of the field of hepatology. Laurence M. Blendis, M.D.
Copyright © 2003 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
--This text refers to an alternate

edition.

From the reviews:

Hepatology deserves the attention of the English-speaking world. It is far less costly than competing texts and is a better teaching and learning vehicle for students at all levels. It is the most readerfriendly liver text I have encountered, and I strongly recommend it.

"During the past decade the discipline of hepatology has burgeoned worldwide … . This book is authoritative and comprehensive with a crisp and clear style and provides an updated and systematic overview of the field. The attractive layout and organisation of the content make the book a delight to browse through and a pleasure to read. The text is abundantly supplemented by 380 colour illustrations … . It will be used by gastroenterologists, liver specialists, surgeons and basic scientists as their regular reference." (J. E. J. Krige, SAJS, Vol. 44 (1), February, 2006)

edition.