Although the peritoneal cavity was the first visceral compartment to be surgically violated, the liver has been the last organ to yield to surgical resection. This has been due to the fact that uncontrollable hemorrhage and infection often occurred during the early attempts at hepatic surgery. With improved surgical techniques and the development of wide-spectrum antibiotics, these dangers have been largely overcome. Another major fear which has shrouded surgical thought pertaining to hepatic surgery has been that of the body's ability to withstand the trauma incident to the removal of a large portion of the liver and concern as to whether the residual hepatic tissue could maintain a normal metabolic balance. Inasmuch as the liver is responsible for at least 250 known physiochemical processes, the fear regarding the maintenance of normal metabolism following major hepatic resection was not entirely unfounded. Although animal experiments have demonstrated that significant portions of
PACK GT, MOLANDER DW. Metabolism Before and After Hepatic Lobectomy for Cancer: Studies in Twenty-Three Patients. AMA Arch Surg. 1960;80(4):685–692. doi:10.1001/archsurg.1960.01290210153030
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