Surgery in Liver Cancer

Hepatectomy

What is Hepatectomy?

A partial hepatectomy, is a kind of Surgery that is performed to remove cancerous tumours from the liver. It is also called a resection of the liver. Because this organ has the remarkable ability to regenerate itself, it can sometimes restore its mass to make up for the tissue lost through Surgery. Liver resection may be advised to resolve Colorectal Cancer that has spread to the liver and help prevent further metastasis.

A physician should generally decide whether a patient is a candidate for a partial hepatectomy by assessing the following:

  • The extent of the cancer – Large or multiple tumours of the liver, as well as tumours that affect different lobes of the liver, may complicate or prevent surgical removal.
  • The location of the tumours – Liver tumours found near the blood vessels may be inoperable; alternative therapies can include intra-arterial Chemotherapy and chemoembolization.
  • The extent of the Surgery required to remove the entire tumour – A significant portion of healthy liver tissue must remain after Surgery to ensure proper functioning and regeneration of the organ.
  • The overall function of the organ – Patients with impaired liver function due to cirrhosis generally cannot tolerate a hepatectomy.
  • The patient’s overall health – A patient must be healthy enough to undergo Surgery and the following rehabilitation period.

How is Hepatectomy performed?

The Surgery is conducted under general anaesthesia and takes three to four hours to complete. The patient lies face-up and both arms are spread away from the body. Often, surgeons use a heating pad and wrappings around the arms and legs to reduce body temperature losses during the operation. The abdomen of the patient is opened by an incision into the upper abdomen and another incision of the midline-extension up to the xiphoid (the cartilage at the bottom of the rib cage). Then the principal steps of a partial hepatectomy proceed as follows:

  • Freeing the liver. The first responsibility of the surgeon is to free the liver by cutting the long fibres that wrap it.
  • Removal of segments. Once the surgeon has freed the liver, they start the removal of the liver segments. The surgeon should be very careful to prevent rupturing important blood vessels to avoid haemorrhage.

What are the side effects of Hepatectomy?

  • Bleeding
  • Infection
  • Complications from anaesthesia
  • Blood clots
  • Pneumonia