肝脏外科实践的转折点:历史回顾。

IF 1.1 Q4 GASTROENTEROLOGY & HEPATOLOGY Annals of hepato-biliary-pancreatic surgery Pub Date : 2024-08-31 Epub Date: 2024-05-16 DOI:10.14701/ahbps.24-039
Giovanni Domenico Tebala, Stefano Avenia, Roberto Cirocchi, Antonella Delvecchio, Jacopo Desiderio, Domenico Di Nardo, Francesca Duro, Alessandro Gemini, Felice Giuliante, Riccardo Memeo, Gennaro Nuzzo
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引用次数: 0

摘要

从古至今,肝脏外科的历史就是一个逐步解决肝脏疾病问题的故事。对人体肝脏解剖学和生理学的完美认识,以及正确的肝脏切除手术的发展,都需要时间和巨大的努力,更主要的是,需要学习和研究那个时代的巨人,他们的名字永远与解剖标志、详尽描述和手术方法联系在一起。外伤后和切除术中控制实质出血是外科医生必须解决的第二个问题。充分了解肝内外血管解剖是发展血管控制技术的必要条件,为肝移植铺平道路。最后但并非最不重要的一点是,切除肝脏后的残余肝功能问题需要通过改变血液流入方向来重新分配肝脏容量的先进技术。这些都是任何年轻外科医生在初次接触肝脏手术时都会遇到的问题。因此,了解肝脏外科的历史演变是一个很好的起点,可以起到示范和指导作用。
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Turning points in the practice of liver surgery: A historical review.

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.

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