Israel Medical Association Journal

Most of the terminology in medicine originates from Greek or Latin, revealing the impact of the ancient Greeks on modern medicine. However, the literature on the etymology of Greek words used routinely in medical practice is sparse. We provide a short guide to the etymology and meaning of Greek words currently used in the field of hepatopancreatobiliary (HPB) anatomy and surgery. Focusing on HPB medical literature, the etymology and origin of Greek words including suffixes and prefixes are shown and analyzed. Thus, anatomy (anatomia) is a Greek word derived from the prefix ana- (on, upon) and the suffix -tomy from the verb temno meaning to cut. Surgery, however, is not a Greek word. The corresponding Greek word is chirourgiki derived from the cheir (hand) and the ergon (action, work) meaning the action made by hands. Understanding the root of Greek terminology leads to an accurate, precise and comprehensive scientific medical language, reflecting the need for a universal medical language as a standardized means of communication within the health care sector. 

 

Background: The diagnostic and therapeutic approach to hilar cholangiocarcinoma and thus the prognosis have changed significantly over the last two decades. Nonetheless, hilar  cholangiocarcinoma  presents a complex surgical challenge.

Objectives: To assess the outcome of the radical approach for the management of types III and IV hilar  cholangiocarcinoma.

Methods: We conducted a retrospective single-center study. Preoperative diagnosis was based on ultrasound, computed tomography and selective percutaneous cholangiography without tissue diagnosis. Surgery was radical and included en-bloc liver, extrahepatic biliary tree and hilar lymph nodes resection, followed by biliary reconstruction with hepatico-jejunostomy.

Results: Fifteen patients (mean age 49 years, range 24–72) were managed accordingly. Anatomic classification of the biliary involvement was Bismuth-Corlette type IIIA (n=4), type IIIB (n=3) and type IV (n=8). The surgical procedures performed included four right hepatic lobectomies, five left hepatic lobectomies and six trisegmentectomies (all extended to the caudate lobe). Complete negative resection margins (R0) were accomplished in 12 cases (80%). Regional lymph node metastases were detected in five cases. There were two perioperative mortalities. Long-term follow-up (mean 30 months, range 6–72) revealed local recurrences in two cases, distant metastases in three, and both local and distant in two cases. Eleven patients are alive and 6 are without evidence of disease. The overall 2- and 5-year survival is 78% and 38% respectively.

Conclusions: In selected patients, the aggressive surgical approach to hilar cholangiocarcinoma is justified and can result in long-term survival.