История билиарной хирургии

From the ancient times biliary surgery attracted a great attention of the doctors and other specialists all over the world. In medieval times, main efforts of medical workers were targeted to the liver and biliary anatomy research. Until the XV century doctors were not aware of the cholelithiasis, first steps in diagnosing and treating this disease were related to obstructive jaundice and biliary abscesses. Surgical treatment in XVIII-XIX centuries included intra-abdominal abscess drainage, pus and bile drainage, gall bladder lithotomy. If biliary colic was associated with local skin hyperemia in right hypochondrium, a surgeon would make an incision in this area, leading to biliary fistula formation and further recovery in some patients. In the middle of XIX century, surgeons started to perform cholecystostomy, removing the stones out of the gall bladder and performing the cholecystopexy to the laparotomy wound. Only in 1882 27-year old Langhenbuch, who was appointed as a head doctor in a hospital in Berlin, was the first one in the world to perform a cholecystectomy in 43-year old patient, who suffered from biliary colics for 16 years. Langhenbuch started to do surgeries on biliary system after many years of training on dead bodies. The peculiar progress in biliary surgery was observed during the last century. Minimally invasive and endoscopic technologies along with general anesthesia and antiseptics made this specialty safe for most of the patients, with cholecystectomy becoming one of the world’s most common surgeries. During the last decades laparoscopic cholecystectomy became the surgery of choice in treating cholelithiasis, and endoscopic papillosphincterotomy and choledocholithotomy in treating choledocholithiasis.