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Evolution in Liver Surgery

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Andriani Oscar Claudio

on 28 October 2015

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Transcript of Evolution in Liver Surgery

Evolution of Liver Surgery
New Ideas upon Old Concepts
VIIth - XIXth Cent
1884-1951
1952-1962
1963- ...
Oscar C. Andriani, MD
HPB Surgery & Liver Transplant Unit
Hospital Universitario Austral
Pilar, Argentina
Pedicular clamping to arrest hemorrhage
Walter Wendel
1911
Pedicular control during hepatectomy
Empirical Era
Carl Langenbuch
1888
1st elective hepatectomy
William W. Keen
1899
1st successful series (76 cases!!)
J. Hogarth Pringle
1908
Jean-Louis Lortat-Jacob
1952

(Portal) Liver segmentation
Ton That Tung
1957

Digitoclassia (finger-crush)
1st right hepatectomy ("reglée")
Claude Couinaud
1957

Francis Glisson
1654

Johannes Walleaus
(U. Leyden)
1640
Thomas Starzl
1963
U. Denver
1st liver transplant
in humans
Sir Roy Y. Calne
1968
U. Cambridge
Immunosuppression
Post-modernism
Martin Heidegger
Jacques Derrida
Inspiration of a new form of art based upon historical processes
Deconstruction
Liver storage (UW)
Liver storage (Imsety)
Claude Huguet
1978
Total vascular exclusion (normothermia)
Joseph Fortner
Hypothermic
liver resections
Masatoshi Makuuchi
1978
Intraoperative ultrasound
The transparent liver
Hepatoscopy
XIXth Cent BC
Assyrian-Babylonian civilization
Teaching hepatoscopy on clay and bronze models
Mentor
Led Telemachus from childhood through adulthood
Segment-oriented resections
Liver segmentation
Intraoperative ultrasound
Henri Bismuth
1982
Hepatectomy "à la carte"
The 3 alliances between liver resections & transplantation
Henri Bismuth
1984
Reduced-sized liver graft
Silvano Raia
(Sao Paulo)
1989
Living donor liver graft
Rudolf Pichlmayr
1988
Split-liver graft
Hepatic regeneration
The Prometheus myth
"Prometheus torment"
Peter Paul Rubens 1611-12
Emil Ponfick
(U. Heidelberg)
Research on liver regeneration
1890
Pierre-Alain Clavien
(U. Zürich)
New strategies in liver surgery
René Adam
2000
Two-stage hepatectomy
Daniel Jaeck
(U. Strasbourg)
Combining portal embolization with 2-stage hepatectomy
Associating Liver Partition with Portal vein ligation in Staged hepatectomy (ALPPS)
Gilles Mentha
2006
Reverse approach (liver 1st!!)
Hippocrates
IV th Cent BC
Cauterization of liver abscess
Radiofrequency
"Heat cures all"
Final remarks
Sir James Cantlie
1897

Peyton Rous (Nobel prize)
1920
Nagy Habib
Habib 4
Pichlmayr
(U. Hannover)
1990
Hjortsjö
Bile ducts
Healey & Schroy
Hepatic veins
1951
1953
JiaHong Dong
Therapeutic effectiveness
Surgical safety
Minimal invasiveness
Precision Liver Surgery
Determinacy
Predictability
Controllability
Integration
Standardization
Individualization
Les arrondissements de Paris
Full transcript