Tebala Giovanni Domenico, Avenia Stefano, Cirocchi Roberto, Delvecchio Antonella, Desiderio Jacopo, Di Nardo Domenico, Duro Francesca, Gemini Alessandro, Giuliante Felice, Memeo Riccardo, Nuzzo Gennaro
Department of Digestive and Emergency Surgery, "S.Maria" Hospital Trust, Terni, Italy.
Department of General and Emergency Surgery, "S.Maria della Misericordia" Hospital Trust, Perugia, Italy.
Ann Hepatobiliary Pancreat Surg. 2024 Aug 31;28(3):271-282. doi: 10.14701/ahbps.24-039. Epub 2024 May 16.
The history of liver surgery is a tale of progressive resolution of issues presenting one after another from ancient times to the present days when dealing with liver ailments. The perfect knowledge of human liver anatomy and physiology and the development of a proper liver resective surgery require time and huge efforts and, mostly, the study and research of giants of their own times, whose names are forever associated with anatomical landmarks, thorough descriptions, and surgical approaches. The control of parenchymal bleeding after trauma and during resection is the second issue that surgeons have to resolve. A good knowledge of intra and extrahepatic vascular anatomy is a necessary condition to develop techniques of vascular control, paving the way to liver transplantation. Last but not least, the issue of residual liver function after resection requires advanced techniques of volume redistribution through redirection of blood inflow. These are the same problems any young surgeon would face when approaching liver surgery for the first time. Therefore, obtaining a wide picture of historical evolution of liver surgery could be a great starting point to serve as an example and a guide.
肝脏手术的历史是一部从古至今在处理肝脏疾病时不断解决接踵而至问题的故事。对人体肝脏解剖学和生理学的完美认知以及合适的肝脏切除手术的发展需要时间和巨大努力,并且在很大程度上依赖于各个时代的杰出人物的研究与探索,他们的名字永远与解剖学标志、详尽描述以及手术方法联系在一起。控制创伤后和切除过程中的实质出血是外科医生必须解决的第二个问题。熟悉肝内和肝外血管解剖是开发血管控制技术的必要条件,为肝脏移植铺平了道路。最后但同样重要的是,切除术后残余肝功能的问题需要通过重新引导血流来进行先进的体积再分布技术。这些都是任何年轻外科医生首次接触肝脏手术时都会面临的相同问题。因此,全面了解肝脏手术的历史演变可以成为一个很好的起点,起到示范和指导作用。