Prometheus Renewed

  • Thomas S. HellingEmail author
  • Daniel Azoulay


An enormous number of liver resections have now been performed, tens of thousands. According to the United States National Inpatient Sample from 2000 to 2012 31,084 open liver resection were recorded with operative mortality generally below 6% [1]. With published studies worldwide of resection for colorectal metastases over the 30 year period from 1987 to 2016 alone, 5207 patients were tabulated for one meta-analysis [2]. Thousands of patients have undergone resections using minimally invasive surgery but adhering to principles no less relevant than open operations: exposure, mobilization, inflow control, and hemostatic parenchymal separation [3]. In less than half a century Jean Lortat-Jacob’s bold adventure in Paris has now become almost commonplace practice in many medical centers. And the pessimistic opinion concerning the much maligned total liver transplant was turned on its ear by daunting efforts of pioneers across the globe that have laid fertile ground for numbers of second and third generation transplanters to give new futures to what were considered hopeless cases decades ago. And this is but a snapshot. Work has not halted. Patients still flock for the relief of metastatic malignancies or burgeoning hepatic cancers. Sallow-eyed, wasted victims of cirrhosis wait patiently for their turn at a second life. The lines will never shorten. It will be the tireless efforts of surgeon-scientists to expand the pathways for correction of nature’s miscalculations. Through rigorous experimentation and plodding determinism these intense individuals will follow in the footsteps of Lortat-Jacob and Hepp and Starzl. As Harvey Cushing stressed, over a century ago:


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Copyright information

© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.University of Mississippi Medical CenterJacksonUSA
  2. 2.Centre Hépato-BiliaireHôpital Universitaire Paul BrousseVillejuifFrance

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