Surgery pp 553-584 | Cite as

Biliary System

  • Hobart W. Harris


The history of biliary tract disease extends over 3500 years, but the birth of modern-day surgical intervention occurred little more than a century ago. Early Egyptians were aware of the liver and biliary system, and assigned these organs significance for divining future events. The oldest recorded case of gallstones was in the mummified remains of the Princess of Amenen from Thebes, circa 1500 b.c. At the time of her death, her well-preserved gallbladder contained at least 30 gallstones. For more than a millennium after her demise, little changed regarding the largely mystical interpretation of the liver and biliary system. But, beginning with Hippocrates (400 b.c.) and extending through the time of Galen (a.d. 200), there gradually developed an appreciation for organ dysfunction and how this might result in disease. In 1506, the detailed description of right upper quadrant abdominal pain associated with the presence of gallstones made by Antonio Benivieni (1440–1502) was published, representing the first correlation of biliary colic with autopsy findings. During the ensuing 250 years, a growing appreciation for human anatomy, combined with the hypothesis that biliary calculi could result from stasis within the gallbladder, culminated in the first reported cholecystectomy. In 1867, through a surgical misadventure, John Stough Bobbs of Indiana opened what he initially mistook for an ovarian cyst in a woman complaining of abdominal pain. No doubt to his surprise, the incision yielded several gallstones, as the cystic structure was instead the gallbladder. After removing the stones, Bobbs closed the cholecystotomy incision and the patient recovered.


Bile Duct Common Bile Duct Laparoscopic Cholecystectomy Acute Cholecystitis Gallbladder Cancer 
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© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Hobart W. Harris

There are no affiliations available

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