Wu Zhiyong, Professor of Surgery, Former Director of General Surgery at Renji Hospital

Introduction

As a surgeon, he has saved countless lives through his exquisite skills and relentless dedication. He continuously honed his abilities in clinical practice, treating each surgery as a challenge to the limits of life and each success as an expansion of medical boundaries. When facing complex cases, he consistently found the optimal treatment plan with a calm mind and firm conviction. His contributions in the field of hepatobiliary and pancreatic surgery have been particularly outstanding, marked by constant innovation and breakthroughs.

His research is closely aligned with clinical practice, focusing on solving real-world medical problems and driving technological advancement. His findings have garnered widespread international academic attention and are widely applied in clinical settings, improving cure rates and patients’ quality of life.

He views cultivating medical talent as his mission, influencing generations of students with his rigorous teaching methods and pragmatic approach. He is a medical scientist who has made outstanding contributions to surgery, and his story inspires every successor in the medical profession.

The Path to Medicine

Wu Zhiyong was born on Chongming Island in the early days of the People’s Republic of China. At the time, the island was a pristine, rural community with a network of waterways, dense reeds, and flocks of water birds. For generations, his family were farmers. While not wealthy, his home was filled with harmony under his parents’ influence.

During his primary school years, Wu lacked the educational resources of city children. With extreme self-discipline, he studied diligently, excelling in his classes by studying at school by day and under a dim kerosene lamp at night.

After a period of farming in his hometown, Wu began to contemplate his future. He witnessed rural doctors, equipped with only simple tools and limited medicine, often failing to improve patients’ conditions. Seeing the suffering of those without basic medical care deeply affected him, inspiring his desire to “study medicine to save lives.”

His thirst for knowledge grew during middle school, especially for the natural sciences. In 1966, the Cultural Revolution erupted, severely disrupting education. Many teachers were forced to stop teaching, and like many of his generation, Wu’s educational path became difficult. However, he did not give up, seizing every opportunity for self-study. He borrowed books, discussed with classmates, and conducted experiments, developing a keen interest in human physiology.

In 1970, during the “Up to the Mountains and Down to the Countryside” movement, Wu’s outstanding academic performance allowed him to pass the entrance exam for Shanghai Second Medical College (now Shanghai Jiao Tong University School of Medicine), making him one of the few fortunate individuals to do so at the time.

In college, Wu thrived. He found that books alone could not satisfy his thirst for medicine; he yearned to understand the mysteries of the human body. He maintained a rigorous learning style, mastering theory while prioritizing hands-on clinical and laboratory work. “My interest in medicine was sparked through clinical practice,” he often said, believing that only through constant practice could one truly master medicine.

Lifelong Learning: The Essential Path for a Doctor’s Growth

After graduating, Wu worked in a hospital’s general surgery department for ten years, accumulating rich clinical experience. As a young surgeon, he faced many challenges, performing complex operations that tested his technical skill and mental fortitude, especially in the emergency room where quick, precise decisions were critical. This high-intensity environment accelerated his growth.

Amid his busy schedule, Wu realized that existing knowledge was insufficient for increasingly complex problems. He understood that medicine is an ever-evolving science and that doctors must keep learning. “The deeper you go into clinical practice,” he told colleagues, “the more you recognize your own deficiencies, and the more you want to enrich yourself through learning.”

In 1982, after a decade of clinical work, Wu pursued a master’s degree under Professor Kuang Yaolin at Shanghai Second Medical College. Professor Kuang was a leading figure in Chinese medicine, expert in both internal medicine and surgery, with outstanding expertise in hepatobiliary and pancreatic surgery. “Professor Kuang’s research thinking was broad-minded, never limited to one discipline,” Wu recalled. “He approached problems from a multidisciplinary perspective, which greatly helped and inspired me.”

Professor Kuang also influenced Wu’s character, encouraging him to read foreign medical literature to stay current. He believed doctors must maintain a thirst for new knowledge, a philosophy that shaped Wu’s entire career. After his master’s, Wu continued his doctoral studies under Professor Kuang, deepening his expertise and learning how to conduct clinical research, laying a solid foundation for his future work.

In 1988, Wu went to Hirosaki University School of Medicine in Japan to further his skills in hepatobiliary and pancreatic surgery. There, he learned advanced surgical techniques and completed research for his doctoral dissertation. More importantly, he gained a new perspective on medicine—not just as a technique, but as a form of respect and care for life. He was deeply moved by the Japanese doctors’ sense of responsibility and professionalism, always putting patients first, conducting rounds meticulously even on holidays.

After returning to China, Wu shared these observations with colleagues and helped revise the hospital’s medical systems, improving efficiency and patient care.

In 1991, after earning his doctorate, Wu moved to the United States for a three-year postdoctoral program at the Louisiana State University Shreveport Medical Center. There, he was exposed to advanced medical technologies and concepts, recognizing that medical progress depends on rigorous research and innovation.

Upon returning to China, Wu integrated these advanced concepts and techniques into his clinical work, continuously improving surgical methods and achieving remarkable results. He introduced new equipment, organized academic exchanges, and elevated his department’s overall medical standards.

In 1997, Wu returned to the U.S. to study liver transplantation at the University of Colorado Transplant Center, one of the world’s earliest and most advanced centers. He mastered the core techniques of liver transplantation and deeply appreciated the strict adherence to medical procedures and regulations.

“My experience abroad showed me the importance my foreign colleagues placed on procedures and their ‘everything for the patient’ spirit,” Wu said. “From directors to interns, they conducted rounds on time every day, without exception. They were patient and kind with families, and provided humane care to terminally ill patients, allowing them to pass with dignity. This respect for life left a deep impression on me.”

Back in China, Wu’s colleagues called him a “walking encyclopedia” for his ability to quickly find solutions to difficult problems, a result of his persistent learning. His bookshelves were filled with surgical texts in Chinese and English, and he read constantly to stay current.

“Actually, I really enjoy learning,” Wu said. “The two most classic books—‘TEXTBOOK’ and ‘Surgery of the Liver, Biliary Tract and Pancreas’—are updated every five years. I started buying ‘TEXTBOOK’ in 1977 and have continued through the 2022 edition. I started ‘Surgery of the Liver…’ with the 2nd edition in 1994 and am now on the 7th. When I attend conferences, I study seriously and never leave the venue. I believe that even in the worst-organized conference, there is always something worth learning.”

As a doctor, Wu firmly believes that only through continuous learning can one remain at the forefront of medicine. He actively participates in academic conferences and encourages young doctors to do the same, telling them, “Medicine is a continuously developing discipline; we must constantly learn to keep pace with the times and better serve our patients.”

Research Originates from Clinical Needs

In medicine, research and clinical practice are two sides of the same coin—both indispensable.

As a clinician and researcher, Wu Zhiyong’s philosophy is that research must serve clinical practice, solve real-world problems, and advance medicine. For over fifty years, he has integrated his research with his clinical work to alleviate patient suffering and drive medical progress.

In the 1960s, gastrinoma was a rare and dangerous disease that was difficult to diagnose. Determined to find an effective method, Wu delved into laboratory research, studying the disease’s mechanism through animal experiments. This led to a new diagnostic and treatment method, which he detailed in his 1989 paper, providing a valuable reference for colleagues in China.

Wu’s foundational and clinical research on cirrhotic portal hypertension is his signature work. He systematically studied the disease’s development and, to address high rates of postoperative complications, he developed a combined shunt-devascularization procedure. This method significantly reduced rebleeding and encephalopathy, becoming the preferred surgical approach for treating esophagogastric variceal bleeding. His work won the Second Prize of the Shanghai Science and Technology Progress Award in 2007, and in 2021, he was named an “Outstanding Contributor to Spleen and Portal Hypertension Surgery in China.”

In the early 1990s, Wu began focusing on pancreatic diseases, proposing new diagnostic and surgical approaches. For pancreatic head masses, he pioneered a method of intraoperative enucleation for immediate pathological examination, improving diagnostic accuracy while preserving function. In treating pancreatic head cancer, he performed complex procedures and developed a new technique for portal vein-superior mesenteric vein (PV-SMV) resection that reduced injury and was widely adopted.

Wu also made outstanding contributions to treating liver and biliary system cancers. For intrahepatic cholangiocarcinoma, he adopted “precise liver resection” to remove tumors while preserving liver function. He developed specific surgical plans for different types of hilar cholangiocarcinoma, significantly improving outcomes. He was the first to systematically review diffuse cholangiocarcinoma, leading to its classification as a distinct type in a 2023 monograph.

In recent years, Wu has focused on the standardized treatment of gastrointestinal tumors. He follows international guidelines like the NCCN but adapts them for China’s national conditions, publishing commentaries to share China’s unique experience.

Through extensive clinical practice, Wu’s modified duodenal diverticulization procedure demonstrates less trauma and better outcomes than traditional surgery. To treat life-threatening duodenal injuries, such as those following ERCP, Wu innovatively refined the procedure. He designed a modified bile duct T-tube drainage and a nasally inserted triple-lumen tube to achieve complete decompression. This less invasive approach avoids complex procedures like partial gastrectomy and effectively prevents severe complications like duodenal fistula.

Wu firmly believes that research must serve patients. He rapidly translates lab findings to the bedside, validating and refining them to create effective medical treatments that have healed countless patients.

His research has profoundly influenced his team, inspiring active engagement in research and clinical innovation. Wu is also deeply committed to medical education, serving on the editorial board of eight surgical textbooks, co-authoring 14 monographs, and publishing over 300 academic papers, significantly contributing to the academic legacy and innovation in surgery.

Patients: The Ultimate Mission

For a physician, pushing the frontiers of medicine—especially during complex, high-risk surgeries—is a fundamental challenge. Wu Zhiyong consistently centers his work on patient well-being, daring to cross medical boundaries to devise optimal treatment strategies.

A 29-year-old patient, Mr. Bao, was admitted with portal hypertension and a splenic artery aneurysm, presenting critical complications including cirrhosis, hypersplenism, esophageal varices, severe coagulopathy, and elevated bilirubin. The risks were immense: uncontrollable hemorrhage from aneurysm rupture, with the potential for postoperative liver failure or infection due to cirrhosis and coagulopathy. Wu convened multidisciplinary consultations, and after rigorous evaluation, performed a splenic artery aneurysm resection with splenectomy. The surgery was successful but technically challenging. Postoperatively, recurrent intra-abdominal bleeding due to coagulopathy and portal hypertension required three exploratory laparotomies. Through meticulous management of these complications, the patient recovered and was discharged, freed from his debilitating condition—a testament to Wu’s team’s relentless dedication and expertise.

Another patient, a 50-year-old from Zhejiang, had undergone a sigmoidectomy for colon cancer but developed multiple lymph node metastases. Conventional therapies were ineffective, and the size and location of the metastases made surgery prohibitively risky. Confronted with the patient’s suffering and limited options, Wu undertook a high-risk resection. After thorough risk disclosure, he completed the tumor excision during a grueling 10-hour surgery. The patient recovered smoothly and was discharged on day 10. Subsequent genetic testing guided targeted therapy and chemotherapy, resulting in eight years of disease-free survival to date—a triumph not only of medical innovation but also of profound respect for life.

Later, a 60-year-old patient from Nanjing presented with recurrent abdominal masses. After multiple surgeries and radiotherapy, he was diagnosed with a malignant gastric stromal tumor. The massive tumor adhered tightly to the rectum, posing extreme surgical risks. Rejected by major hospitals, he sought Wu’s care. Wu assessed the case and proceeded despite the challenges: severe adhesions and the tumor’s proximity to critical vasculature. After another difficult 10-hour operation, the patient recovered and was discharged on day 10. The surgery not only saved his life but restored his future.

Wu’s contributions extend beyond individual patients to advancing surgical innovation. Since the 1990s, he pioneered specialized hepatic segmentectomies, hemihepatectomies, and extended hepatectomies at his hospital, promoting precision liver resection. In transplantation, he performed Renji Hospital’s first liver transplant in 2001, offering new hope. In 2008, he proposed novel insights into intrahepatic cholangiocarcinoma, driving global progress in hepatobiliary oncology.

Rigor, Responsibility, Pragmatism: Cultivating Excellence

Wu understands that medical progress relies not only on generational efforts but also on education to cultivate successors with exceptional skills and professionalism. Amid demanding clinical and research commitments, he prioritizes mentoring, nurturing talent for the future of general surgery in China.

His unwavering standard for students is: “rigor, responsibility, pragmatism.” Medicine demands supreme expertise and accountability; students must master theoretical foundations and adopt meticulous research approaches before entering clinical practice. Whether in classrooms or labs, he insists on precision and excellence.

Wu emphasizes that medical research should transcend publication—it must solve clinical problems and tangibly benefit patients. He guides students to select research topics that address real-world clinical challenges, enhancing their translational impact. Despite his heavy workload, he personally mentors every student, refining their research direction and meticulously revising their manuscripts. His dedication inspires his students, many of whom become leaders in general surgery.

As a mentor, he leads by example. In clinical settings, he demonstrates how to apply theory to practice. In the operating room, he not only showcases surgical techniques but also explains the scientific rationale and clinical significance of each step. Students learn not only technical mastery but also his unwavering focus on patient care.

This “teaching by both word and deed” extends to his research ethos. As a scientist, he never rests on his laurels, maintaining a deep curiosity and passion for his work. He shares his research experiences, encouraging students to innovate boldly while remaining grounded in methodological rigor.

This mentorship profoundly shapes his students. They gain not only knowledge and skills but also a strong sense of ethical and scholarly integrity. Many graduates become chief physicians and academic leaders at renowned hospitals, their achievements reflecting Wu’s rigorous training.

Over more than 40 years of teaching, Wu has mentored dozens of master’s and doctoral students. Now practicing across the country, they form the backbone of general surgery departments, with many achieving distinction in their fields. Cao Hui, the current Director of Surgical Teaching and General Surgery at Renji Hospital, exemplifies this legacy.

Wu often states: “Achieving ‘rational diagnosis, rational testing, rational treatment, rational medication’ for patients demands profound medical knowledge, exquisite skills, rich clinical experience, deep empathy, and unwavering responsibility.” He believes physicians must always prioritize the patient’s interests, tailoring personalized treatment plans with professionalism and dedication throughout their care.

Reflecting on his 40-year career, Wu acknowledges that medical advancement depends on generational efforts and robust education. To him, tackling formidable challenges to breach the “frontiers of life,” a relentless dedication to saving lives, a commitment to healing others with benevolent skill, and a lifelong devotion to medical science embody a physician’s calling—and their greatest joy, pride, and fulfillment.