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1、CHAPTER54THELIVERJasonK.Sicklick,MichaelD’Angelica,andYumanFongknowledgeofLortat-Jacob’sreport.Descriptionsofthesegmen-historicalperspectivetalnatureofliveranatomybyCouinaud,Woodsmith,andanatomyandphysiologyGoldburnein1957openedthedoorevenwiderandintroducedportalhypertensionthemoderneraofliversurge
2、ry.infectiousdiseasesDespitetheseimprovements,hepaticsurgerywasplaguedneoplasmsbytremendousoperativemorbidityandmortalityfromthehemobilia1950sintothe1980s.Operativemortalityratesinexcessof20%viralhepatitisandthesurgeonwerecommonandusuallyrelatedtomassivehemorrhage.Manysurgeonswerereluctanttoperform
3、hepaticsurgerybecauseoftheseresultsand,understandably,manyphysicianswerereluc-tanttoreferpatientsforhepatectomy.WiththecourageofHISTORICALPERSPECTIVEpatientsandtheirfamilies,aswellasthepersistenceofsurgeons,Thesurfaceanatomyoftheliverwasdescribedasearlyas2000safehepaticsurgeryhasnowbeenrealized.Aco
4、mpletelistisnotyearsBCbytheancientBabylonians.EvenHippocratesunder-possiblehere,butcourageoushepaticsurgeonssuchasBlumgart,stoodanddescribedtheseriousnessofliverinjury.In1654,Bismuth,Longmire,Fortner,Schwartz,Starzl,andTondeserveFrancisGlissonwasthefirstphysiciantodescribetheessentialmention.anatom
5、yofthebloodvesselsoftheliveraccurately.Thebegin-Advancesinanesthesia,intensivecare,antibiotics,andningsofliversurgeryaredescribedasrudimentaryexcisionsofinterventionalradiologictechniqueshavealsocontributedevisceratedliverfrompenetratingtrauma.Thefirstdocumentedtremendouslytothesafetyofmajorhepatic
6、surgery.TotalcaseofapartialhepatectomyiscreditedtoBerta,whoampu-hepatectomywithlivertransplantationandlivedonorpartialtatedaportionofprotrudingliverinapatientwithaself-hepatectomyfortransplantationarenowperformedroutinelyininflictedstabwoundin1716.specializedtransplantationcenters.Partialhepatectom
7、yforaInthelate1800s,thefirstgastrectomiesandcholecystecto-largenumberofindicationsisnowperformedthroughoutthemieswerebeingperformedinEurope.Atthattime,surgeryonworldinspecializedcenters,withmortalityratesof