Gastrointestinal Surgery

Abstract

Every surgeon who operates has complications. The surgeon who says he never has a complication, does not operate. It is a matter of the law of aver- ages. Virtually every surgical procedure that is performed has a certain inci- dence of complications. It can be as low as 1 %, after an inguinal hernia repair, or as high as 45 or 50 % after a pancreaticoduodenectomy. If enough of a surgical procedure is performed, a complication will result. Every expe- rienced surgeon is aware of the statement “good judgment comes from expe- rience, and experience comes from bad judgment.” As the busy surgeon gainsexperience, he or she will make mistakes that will add to their experience, and result in better judgment the next time that situation is encountered. It has been shown for many complex operative procedures in recent years that larger volume leads to better outcomes. Part of the reason is that larger volume leads to more complications, which leads to more experience, which leads to better results. The high-volume surgeon gains better knowledge of the anatomy of the procedure, understands the complications that can occur, and learns to intervene earlier, all of which lead to better management. The list of authors in this text entitled Gastrointestinal Surgery: Man- agement of Complex Perioperative Complications reads like a who’s who in surgery. The fact that these superb, experienced surgeons are willing to participate in this text demonstrates that these high-volume surgeons realize that complications are inevitable, and that their high volume has lead them to manage these complications earlier. In turn, the authors are able to provide many excellent suggestions on how to intervene to manage them. It is a text- book that I predict will be imminently successful, and one that every surgeon who performs complex gastrointestinal surgeries should have in their posses- sion. I commend the authors/editors on putting together this outstanding text.