Development of hepatopancreatobiliary surgery in China and the challenges and opportunities in synchronizing itself with the world

Abstract

This article traced how western medicine and surgery were introduced into China, described where Chinese surgery stands currently at the international scene, and proposed future strategies as to how Chinese surgery can go internationally. Surgery, a major component of western medicine,was first introduced into China in the late 19th and early 20th centuries through the missionaries and the merchants of the East Indian Company. Surgical centers were soon established in the big cities along the coastal region, then spread inland along the Yellow River, the Yangtze River and the Pearl River. The establishment of general surgery centers soon led to the development of the subspecialty in hepatopancreatobiliary surgery because of high prevalence of hepatitis B related hepatocellular carcinoma, intrahepatic stones, portal hypertension caused by schistosomiasis and pancreatic disease. For historical reasons,Chinese surgery was cut off from the outside world in the 1960s.This led to the development of Chinese surgery along a different path from that taken internationally. With the opening up of China in the 1980s, and the recent economic developments,Chinese surgery needs to merge with surgery in the rest of the world. Suggested proposal for future strategies for Chinese surgery to go internationally include undergraduate medical reform, introduction of structured surgical training and examination for the whole country, life long continuing medical education for all surgeons, academic exchanges with internationally renowned centers, publication in international peer-review journals, active involvement in international surgical societies and conferences. Key words: Hepatic surgery; Biliary surgery; Pancreatic surgery