Hepatology

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Overview

Fluoroscopic image of common bile duct

Hepatology is the branch of medicine that incorporates study of liver, gallbladder, biliary tree and pancreas as well as management of their disorders. Etymologically the word Hepatology is formed of ancient Greek hepar(ηπαρ) or hepato-(ηπατο-) meaning ' liver' and suffix -logia(-λογια) meaning 'word' or 'speech'. Although traditionally considered a sub-specialty of gastroenterology, rapid expansion has led in some countries to doctors specialising solely on this area, who are called hepatologists.

Diseases and complications related to viral hepatitis and alcohol are the main reason for seeking specialist advice. One third of world population has been infected with Hepatitis B virus at some point in their life. Although most of them would clear the virus from the body, approximately 350 million have become persistent carriers. Up to 80% of liver cancers can be attributed to either hepatitis B or Hepatitis C virus. In terms of number of mortality, the former is second only to smoking among known agents causing cancer. Hopefully, widespread implementation of vaccination and strict screening before blood transfusion are going to lower the infection rate in future.

However in many countries overall alcohol intake is on the rise and as one can expect, number of people with cirrhosis and other related complications are increasing.

Schematic diagram of Hepato-biliary system

Scope of the specialty

As for many medical specialties, patients are most likely to be referred by family physicians( i.e. GP) or by doctors from different disciplines. The reasons might be:

History

File:Blumberg.jpg
Dr. B Blumberg, Awarded Noble prize 1976 for discovery of Hepatitis B virus

Evidence from autopsies on Egyptian mummies suggest that liver damage from parasitic infection Bilharziasis was widespread in the ancient society.[1] It is possible that Greeks might be aware of liver's ability to exponentially duplicate as illustrated by Prometheus story. However knowledge about liver diseases in antiquity was some what sketchy. Most of the important advances in the field were made in last 50 years.

Disease classification

1. International Classification of Disease (ICD 2007)/ WHO classification:

2. MeSH (medical subject heading):

3.National Library of Medicine Catalogue (NLM classification 2007):

Also see Hepato-biliary diseases

Important procedures

Publication

  • The American Journal of Gastroenterology (Journal of the American College of Gastroenterology)
  • The American Journal of Physiology - Gastrointestinal and Liver Physiology
  • Archives of Gastroenterohepatology
  • Comparative Hepatology
  • Current Hepatitis Reports
  • European Journal of Gastroenterology and Hepatology
  • Gastroenterología y Hepatología
  • Gastroenterology (journal of the American Gastroenterological Association)
  • Hepatobiliary & pancreatic diseases international : HBPD INT (First Affiliated Hospital, Zhejiang University School of Medicine, China)
  • Hepatology (journal of the American Association for the Study of Liver Diseases)
  • HPB
  • Journal of Gastroenterology and Hepatology
  • HPB Surgery
  • Journal of Hepato-Biliary-Pancreatic Surgery
  • Journal of Hepatology (journal of the European Association for the Study of Liver Diseases)
  • Journal of Viral Hepatitis
  • Liver
  • Liver Transplantation (from the American Association for the Study of Liver Diseases)
  • Nature clinical practice. Gastroenterology & hepatology.

Societies

  • American Association for the Study of Liver Disease
  • American College of Gastroenterology
  • American Gastroenterological Association
  • American Hepato-Pancreato-Biliary Association
  • American Liver Society
  • Austrian Society of Gastroenterology and Hepatology
  • British Society of Paediatric Gastroenterology, Hepatology and Nutrition
  • Canadian Association for the Study of the Liver
  • Czech Society of Hepatology
  • Danish Association for the Study of the Liver
  • European Association for the Study of the Liver
  • European Society of Paediatric Gastroenterology, Hepatology and Nutrition
  • French Association for the Study of the Liver
  • International Hepato-Pancreato-Biliary Association
  • International Liver Transplantation Society
  • Israel Association for the Study of the Liver
  • North American Society for Pediatric Gastroenterology, Hepatology and Nutrition
  • Society for Surgery of the Alimentary Tract
  • Spanish Society of Pediatric Gastroenterology, Hepatology and Nutrition
  • Swiss Association for the Study of the Liver
  • Turkish Association for the Study of the Liver

References

  1. Rosalie David A, Contis G (1996). "Paleopathology on schistosomiasis in Egyptian mummies". Parasitol. Today (Regul. Ed.). 12 (4): 167. PMID 15275234.
  2. "History of Liver, Gallbladder, and Spleen". Retrieved 2007-05-18.
  3. 3.0 3.1 H S.J. Lee (Editor). Dates in Gastroenterology: A Chronological Record of Progress in Gastroenterology over the Last Millennium (Landmarks in Medicine). Informa Healthcare. ISBN 1-85070-502-X.
  4. Moodley J, Singh B, Lalloo S, Pershad S, Robbs JV (2001). "Non-operative management of haemobilia". The British journal of surgery. 88 (8): 1073–6. doi:10.1046/j.0007-1323.2001.01825.x. PMID 11488792.
  5. "Victor Charles Hanot (www.whonamedit.com)". Retrieved 2007-05-18.
  6. "eMedicine - History of Pediatric Liver Transplantation : Article by Beth A Carter, MD". Retrieved 2007-05-18.
  7. "History of Liver Transplantation". Retrieved 2007-05-18.
  8. STARZL TE, MARCHIORO TL, VONKAULLA KN, HERMANN G, BRITTAIN RS, WADDELL WR (1963). "HOMOTRANSPLANTATION OF THE LIVER IN HUMANS". Surgery, gynecology & obstetrics. 117: 659–76. PMID 14100514.
  9. "Baruch S. Blumberg - Autobiography". Retrieved 2007-05-18.

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