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Hepatology

life science Maturity 11-13 Next article →

Hepatology is a specialized branch of medicine. It involves the study of the liver, gallbladder, pancreas, and the biliary tree. The biliary tree is a system of tubes that carries fluids.

Hepato-biliary
Hepato-biliary

Doctors who focus on these specific areas are called hepatologists. While this field was once a sub-specialty of gastroenterology, it has expanded greatly. Today, many doctors specialize only in these organs and their many disorders.

There are many ways a patient might need a hepatologist. A family doctor might refer a patient after seeing abnormal blood tests. These tests can suggest that the liver is not working correctly. Other signs include jaundice, which is a yellowing of the skin or eyes. Patients may also experience ascites, which is a swelling of the abdomen caused by fluid accumulation.

ERCP stone
ERCP stone

Some patients are referred because of a paracetamol overdose, which can harm the liver. Others may have issues like pancreatitis, often caused by gallstones or alcohol.

Many different conditions can affect these organs. Viral hepatitis is a major cause of liver disease. More than two billion people have been infected with the hepatitis B virus. About 350 million of those people are persistent carriers. Hepatitis B and hepatitis C are also linked to cancer. In fact, up to 80% of liver cancers are attributed to these two viruses.

Blumberg
Blumberg

Another common issue is cirrhosis, which is serious liver damage. This often results from increased alcohol consumption in many countries.

Medical professionals use several specialized procedures to help patients. One important method is called ERCP, or endoscopic retrograde cholangiopancreatography. This procedure allows doctors to diagnose and manage diseases within the biliary tree.

ERCP stone
ERCP stone

Other advanced techniques include TPC, which is transhepatic pancreato-cholangiography. There is also a procedure called TIPSS, known as transjugular intrahepatic portosystemic shunt. For very advanced cases, doctors may perform a liver or pancreas transplant to save a patient's life.

Humans have been interested in the liver for thousands of years. Evidence from Egyptian mummies shows liver damage from a parasite called bilharziasis. In ancient times, the Roman anatomist Galen believed the liver was the body's principal organ. He also identified how it relates to the gallbladder and spleen. In the medieval period, a scholar named Avicenna noted that urine could help diagnose liver conditions. Many important scientific breakthroughs, however, occurred in just the last 50 years.

Major milestones in hepatology changed how we treat patients. In 1963, Dr. Thomas E. Starzl performed the first human liver transplant. He did this after perfecting the technique on canine livers. In 1966, Baruch S. Blumberg discovered the hepatitis B virus.

Blumberg
Blumberg

He developed the first vaccine for it in 1969 and won a Nobel Prize in 1976. Later, in 1989, investigators identified the hepatitis C virus. By 1992, scientists created a blood test to detect hepatitis C in donated blood.

Modern hepatology relies on many different types of expertise. When treating cancer of the liver or pancreas, doctors often use a multi-disciplinary approach. This means they work together with other experts, such as oncologists. They also work with microbiologists to study infections like kala-azar or schistosomiasis. By combining different fields, doctors can better understand and manage complex diseases of the digestive system.

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Blumberg.jpg
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