胆道外科历史及现代胆道外科技术体系的建立

History of biliary surgery and establishment of mordern biliary surgery technology system

胆道外科的历史源远流长。自文艺复兴时期以来,无数前辈从认识胆道开始,由胆囊切除发展到肝外胆管探查,取得显著进步。黄志强院士首次采用肝叶切除治疗复杂肝胆管结石病,将胆道外科从肝外胆管发展到肝内胆管。精准胆道外科技术体系的建立与成熟,标志着胆道外科迈入“段”的时代。然而,由于诊断与治疗全流程中理念与技术的诸多不确定性,胆道外科仍然是目前腹部外科最复杂,预后亟需改善的领域之一。未来的胆道外科将突破现有的肝段水平,通过与各领域的专家合作,作出基于大数据、人工智能背景的医疗决策并开展更加精准的手术作业。笔者通过回顾胆道外科的历史,分析现状,旨在探索未来胆道外科的发展趋势及目标。

Biliary surgery has a long history.Since the Renaissance era,countless predece-ssors began to understand the biliary ducts,developed from cholecystectomy to extrahepatic bile duct exploration,and made significant progress.Academician Zhiqiang Huang firstly applied hepatectomy to the treatment of complex hepatolithiasis,and developed biliary surgery from extrahepatic bile duct to intrahepatic bile duct.The establishment and maturity of the"Precision biliary surgery technology system"marks the era of"segment"in biliary surgery.However,due to the many uncertainties of the concept and technology in the entire diagnosis and treatment process,biliary surgery is still one of the most complicated areas in abdominal surgery,and the prognosis is in urgent need of improvement.In the future,biliary surgery will make a breakthrough from the current hepatic segment to molecular level.Surgeons will cooperate with experts in various fields,make medical decisions based on big data and artificial intelligence,and perform more precise surgeries.