Carl Langenbuch and the Lazarus Hospital: events and circumstances surrounding the first cholecystectomy.

Carl Langenbuch performed the first cholecystectomy at the Lazarus Hospital in Berlin in July 1882. This operation followed scientific experiment, careful thought, cadaver dissections and careful patient selection. Langenbuch's career was linked with the Lazarus Hospital in Berlin, to which he was appointed as Director at the age of 27. The hospital was then 4 years old and in a poor area of Berlin, and they grew in reputation together. Going through repeated troubled times, this hospital has withstood financial disaster, three wars, an occupation and the ambitions of administrators and developers. Treatment for cholecystitis before Langenbuch was stone extraction from spontaneous cutaneous biliary fistula or skin incision of near-pointing empyema. Cholecystostomy was carried out by Bobbs (1867), by Sims (1878), and championed by Kocher (1878) and Tait (1879). Langenbuch carried out a cholecystectomy in 1882 and subsequently recommended choledochotomy, duodenotomy and sphincterotomy in the management of stones in the bile ducts. He carried out one of the earlier major right liver resections in 1888. Also, he was famous for his sciatic nerve stretching for tabes dorsalis, management of gunshot wounds and his dissertations at the German Surgical Society before becoming renowned for cholecystectomy. The surgical world owes Langenbuch proper acknowledgement for his contribution to hepatobiliary surgery.