A Worldwide Phenomenon: Liver Surgery in the Far East

Abstract

Japanese physicians had maintained a close association with German surgery since the Meiji Restoration of 1868, which hoped to reintroduce advances in Western science to replace the previous closed-door attitude of the shogunates. A number of Japanese surgeons had studied under the Teutonic masters Billroth, Vincenz Czerny, Bernhard von Langenbeck, and Ernst von Bergmann and returned to their homeland where a robust Western-style university medical system was developing. The Japanese Surgical Society was founded in 1898 and began annual congresses to showcase Japanese surgical efforts that were far in advance of their mainland Asian colleagues. It was the Japanese delegation to the International Society of Surgery that petitioned for Germany and Austria to be readmitted after the conflagration of World War I [1]. In the interwar period the evolving Nipponese hospital and medical education system was generating admirable clinical results. By the 1930s Japanese surgeon Komei Nakayama reported a remarkably low mortality rate of 16.7% following esophagectomy for cancer [2]. At the same time Hiroshige Shiota had perfected radical methods to eradicate gastric cancer, again with a drastic reduction in operative mortality. While World War II was devastating for Japan’s medical system, energetic physician-scholars, with the support of the occupying Allied powers, quickly latched onto American medicine and, from a ruinous health system, began rebuilding the high standards of care they had formerly known.