Hepatology is the branch of medicine that incorporates the study of liver, gallbladder, biliary tree, and pancreas as well as management of their disorders. Although traditionally considered a sub-specialty of gastroenterology, rapid expansion has led in some countries to doctors specializing 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. More than two billion people have been infected with hepatitis B virus at some point in their life, and approximately 350 million have become persistent carriers.[1] Up to 80% of liver cancers can be attributed to either hepatitis B or hepatitis C virus. In terms of mortality, the former is second only to smoking among known agents causing cancer. With more widespread implementation of vaccination and strict screening before blood transfusion, lower infection rates are expected in the future.[citation needed] In many countries, however, overall alcohol consumption is increasing, and consequently the number of people with cirrhosis and other related complications is commensurately increasing.[citation needed]
Schematic diagram of hepato-biliary system
Scope of specialty
As for many medical specialties, patients are most likely to be referred by family physicians (i.e., GP) or by physicians from different disciplines. The reasons might be:
Cancer of above organs. Usually multi-disciplinary approach is undertaken with involvement of oncologist and other experts.
History
Dr. B Blumberg, awarded Nobel prize 1976 for discovery of hepatitis B virus
Evidence from autopsies on Egyptian mummies suggests that liver damage from the parasitic infection bilharziasis was widespread in the ancient society.[2]
It is possible that the Greeks may have been aware of the liver's ability to exponentially duplicate as illustrated by the story of Prometheus. However, knowledge about liver disease in antiquity is questionable. Most of the important advances in the field have been made in the last 50 years.[when?]
The first human liver transplant was performed in 1963 by Dr. Thomas E. Starzl on a three-year-old male afflicted with biliary atresia after perfecting the technique on canine livers.[9][10]
In 1989, investigators from the CDC (Daniel W. Bradley) and Chiron (Michael Houghton) identified the hepatitis C virus, which had previously been known as non-A, non-B hepatitis and could not be detected in the blood supply.[12]
Only in 1992 was a blood test created that could detect hepatitis C in donated blood.[12]
The word hepatology is from Ancient Greek ἧπαρ (hepar) or ἡπατο- (hepato-), meaning "liver", and -λογία (-logia), meaning "study".
^Rosalie David A, Contis G (1996). "Paleopathology on schistosomiasis in Egyptian mummies". Parasitol. Today (Regul. Ed.). 12 (4): 167. doi:10.1016/0169-4758(96)80811-8. PMID15275234.
^ abH. S.J. Lee, ed. (1999). Dates in Gastroenterology: A Chronological Record of Progress in Gastroenterology over the Last Millennium (Landmarks in Medicine). Informa Healthcare. ISBN1-85070-502-X.
