[Liver surgery after the millennium]

Since 1906 according to the invitation of the Hungarian Surgical Society mainly surgeons have had the honour to give the János Balassa memorial lecture. In accordance with the traditions the first part of the lecture is a commemoration at János Balassa and the second part deals with the work of the invited lecturer. This year the 84th memorial lecture was held. The speaker besides reviewing János Balassa's biographical data pointed out his outstanding characteristics. Balassa was not only the founder of the first surgical school but a prominent intellectual leader in his age. He summarised the two basic conceptions of his oeuvre in the lecture that he held after being appointed to the leader of the surgical department; to raise surgery from the level of bunglers and barbers to the up-to-date surgical standards. His other statement is valid even today: surgery is equivalent with internal medicine among the clinical sciences but he did not intended to split them up. In the second part of the lecture the speaker presented his own work in hepatic surgery. He highlighted the present concerns of the history of hepatic surgery. He summarised separately the change of approaches in the indications of primary and secondary hepatic tumours. He determined the R0 resection as the basic factor of hepatic surgery. In his lecture he reported the alterations and expectations of surgery in hepatocellular carcinoma and metastatic hepatic tumours. He pointed out the increasing radicality in this field. He reviewed the new surgical techniques that give better results. He emphasised the importance of bloodless surgery in his own experience with Baron knack and different hepatic parenchyma separating techniques. He mentioned the role of oncology in connection with hepatic surgery, especially the results of molecular biology. In his lecture it stood out that he holds the long-term survival the most important result of hepatic surgery but he mentioned several other prognostic factors. Finally he gave an overview about the potential future of hepatic surgery.