Grey Turner Memorial Lecture. Changing Role of Liver Surgeons

The history of liver surgery, hepatectomy and haemostasis

“…McLane Tiffany [28] of Baltimore has been credited with the first liver resection in the United States, but it is unknown if he actually resected any liver parenchyma. However, his lack of personal experience did not stop him from publishing another report [29] in 1890, in which he expressed confidence and enthu- [12][13][14][15][16]. They showed that transection of the liver substance was possible; three fourths of the liver could be resected with survival and the liver would regenerate close to its original weight.…”

“…Even today it is referred to as Glisson's capsule. His studies on the intrahepatic vasculature stand out as monumental and after some years he concluded that the liver vasculature was distributed throughout the liver, branching from both the hepatic and portal veins [12]. Glisson had no microscope, yet he correctly predicted the presence of tiny vascular channels connecting the portal and hepatic venous system.…”

“…These clamps were devised to compress the liver to achieve haemostasis. Various clamps were then designed during the 1970s to reduce blood loss during liver resection [12]. Stucke is credited with the first description of a liver clamp in 1961, followed by Storm and Longmire in 1971 [86,87] but Nakayama in 1958 may have been the first to design a clamp specifically for the liver [88].…”