Hepatectomy

What is hepatectomy and why is it done?

Hepatectomy is a surgical procedure in which a part or the whole liver is removed. It is done to treat liver cancer.

What are the symptoms of

liver cancer?

Following are the symptoms of liver cancer:

  • Stomach Pain
  • Sudden weight loss
  • Nausea and vomiting
  • Yellowing of the skin
  • Loss of appetite
  • Fatigue and weakness
  • Chalky stools
  • Swelling of abdomen
  • Jaundice

How is liver cancer diagnosed and

treated?

Blood tests are the primary indicators of abnormalities in the functioning of the body. Initially blood tests are conducted to diagnose cancer.

Liver biopsy is a sure and an efficient method to diagnose cancer. During liver biopsy a part of the liver tissue is removed and sent to the laboratory for tests to arrive at a definitive conclusion about the liver cancer.

Process of liver biopsy: during liver biopsy a small needle is inserted through the skin and to obtain a tissue sample, then this sample is sent to the lab and observed under the microscope for cancer cells.

Scans are also helpful in determining the extent and spread of cancer. CT scans, MRI scans are helpful in this regard.

What are the treatments available for

liver cancer?

Localized approach

Heating the cancer cells: 

Using imaging tests like CT scan, MRI scan and ultrasound as a guide, thin needles are inserted in the abdomen by making small incisions and electric current is passed through to heat and destroy the cancer cells.

Freezing cancer cells:

With the help of ultrasound images to locate the doctor places an instrument (cryoprobe) containing liquid nitrogen directly onto liver tumors and due to the freezing temperature the cells are destroyed.

Alcohol injections to the tumor:

Alcohol is injected to the cancer cells either through the skin or during a surgery that makes the cells die.

Chemotherapy:

Chemotherapy involves supplying strong anti-cancer drugs directly to the liver.

Surgical approach

In surgical approach either partial hepatectomy is carried out, where a part of the liver is removed or completed liver transplant is done.

In an open procedure, under the influence of general anesthesia, incisions are made in the abdomen region and the surgeon makes his way through other organs in the region; when the liver is located the affected part is slowly disconnected and then removed.

An open procedure is generally adopted for complete liver transplant.

A constant supply of nutrients is maintained through the IV and vitals are constantly monitored.

If a partial hepatectomy is to be carried out then the doctors opt for a minimally invasive approach.

 A general anesthesia will be administered to the patient and as a result he/she will be asleep during the surgery.

Once the patient is asleep the process begins by making incisions near the belly button and a small device is inserted which is called a port; it creates an opening that will be filled with gas (carbon dioxide) in the abdomen region.

Through these incisions a Laparoscope (a Laparoscope is a small instrument with a narrow tube which has light source and camera at the end of the tube) is inserted and using the Laparoscope’s video camera the surgeon is able to locate the affected body part and through the other incisions that are made the damaged/affected (tumors and the affected liver lobe) part is removed with the help of surgical equipment; after this the incisions are sealed using a surgical glue or staples.

This process is called liver resection.

How long does it take to

recover?

The recovery time for Laparoscopic surgeries is very less and one can return to normal life within days of surgery, but they should avoid heavy lifting. The soreness after the surgery lasts for 48 hours and it can extend up to weeks depending upon the individual.

In an open surgery the doctors will take a call on the discharge and return of the patient to his/her house.

If it’s a laparoscopic approach, one might feel nauseated post-surgery, this might be due to anesthesia administered for the purpose of the surgery.

Post-surgery one might feel shoulder pain because of the gas that was pumped in during the surgery, which will go away within 48 hours.

The patient is advised complete bed rest for a month and regular appointments are scheduled by the doctor to check how the patient’s body is responding to the post-surgery treatment.

The doctors will prescribe vitamin and mineral tablets in addition to painkillers.

The patient will also have to undergo a series of scans and tests after the surgery to monitor the condition of the liver.

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