T. Bloodhart – illustratör

As research in liver disease has greatly expanded over the past few decades the etiology, pathology, and natural history of many hepatic disorders have been clearly defined. Many new and accurate diagnostic tools are now available. In spite of all this progress the treatment of many liver diseases remains ameliorative. Nevertheless a more aggressive and successful surgical approach has taken place in regard to many diseases of the liver in part due to the pioneering work of Dr. William P. Longmire, Jr. and his colleagues. Dr. Longmire was among the early advocates of liver resection of neoplasms, successfully remov­ ing a large benign tumor of the liver in 1946. In the following decades his contributions covered the surgical treatment of trauma, tumors, cysts, and other congenital abnormalities. He has performed hundreds of operations on patients with these disorders. In 1948 he reported a procedure now named for him, in which intractable common duct obstruction was relieved by partial left hepatectomy and cholan­ giojejunostomy. He was one of the first to advocate side-to-side portacaval shunt for portal hypertension. Other essential contributions by this master surgeon were the periodic reviews that covered the advances in his field. Dr. Longmire, with his scholarly approach and broad background of knowl­ edge in all aspects of hepatic surgery, is exceptionally qualified to write this book. He and his colleague, Dr. Ronald K. Tompkins, are to be congratulated on this complete treatise.

Of all the developing fields of surgery, few have had the impact of vascular surgery in affecting so large a segment of the population with its potential for relief of disability or the prolongation of life. As would be anticipated, the interest of surgeons in this evolving specialty has been largely focused upon the selection of the most appropriate operations and the development of modifications or new procedures to overcome the limitations of previous ones. The literature contains numerous conflicting claims on the relative merits of various procedures. Those approaching this field for the first time may understandably be confused. Yet, if one were to approach any single vascular surgeon at any given time, he would, upon request, receive a firm and precise listing of preferred procedures. The procedures described in this two-volume publication are those which we currently favor. Their selection is the result of continuing anal­ ysis of our own experience of the last 25 years. All patients have been available for prolonged follow-up evaluation. Late failures often identified techniques that lessened the durability of initially satisfactory operations and stimulated the development of modifications or trials with alternate op­ erations. Particular attention is directed here to the manner in which knowledge of the natural history of disease influences the choice of opera­ tion.