Upper GI
Liver Cancer
Liver Resection: Patient Information
Liver resection, also known as hepatic resection, is a surgical procedure to remove a portion of the liver.
This procedure is often used to treat liver cancer, liver metastases (cancer that has spread to the liver), and certain benign liver conditions. The liver’s unique ability to regenerate allows for significant portions to be removed, and it can regrow to its original size within a few months.
Indications for Liver Resection
- Primary Liver Cancer: Such as hepatocellular carcinoma (HCC) or cholangiocarcinoma.
- Metastatic Liver Cancer: Cancers that have spread to the liver from other organs, such as colorectal cancer.
- Benign Liver Tumours: Such as adenomas or large hemangiomas that cause symptoms.
- Liver Cysts: Large or symptomatic cysts.
- Liver Trauma: Severe injury to the liver requiring surgical intervention.
Preoperative Preparation
- Medical Evaluation: Comprehensive assessment including medical history, physical examination, blood tests, and imaging studies (CT scan, MRI, ultrasound).
- Liver Function Tests: To evaluate the liver’s ability to withstand surgery and regenerate.
- Nutritional Assessment: Ensuring optimal nutritional status for recovery.
- Preoperative Instructions: Fasting for 6 hours before surgery, stopping certain medications as instructed by the doctor.
The Surgical Procedure
- Anaesthesia: General anaesthesia is administered, meaning you will be asleep and pain-free during the procedure.
- Incision: The surgeon makes an incision in the abdomen to access the liver.
- Open Surgery: A larger incision provides direct access to the liver.
- Laparoscopic Surgery: Smaller incisions with the use of a camera and specialized instruments.
- Resection The diseased portion of the liver is carefully removed. The remaining liver tissue is preserved to maintain liver function.
- Closure: The incisions are closed with sutures or staples.
Postoperative Care
Hospital Stay
Typically, patients stay in the hospital for 7 days for monitoring and initial recovery.
Pain Management
Pain medications will be provided to manage post-operative pain.
Diet
Initially, a liquid diet, gradually progressing to solid foods as tolerated.
Activity
Gradual return to normal activities. Avoid heavy lifting and strenuous activities for several weeks.
Incision Care
Keeping the incision site clean and dry, following the doctor’s instructions regarding wound care and bathing.
Follow-up
Regular check-ups to monitor recovery, liver function, and for any signs of complications.
Trusted for care
Dr Wang and his team are respected and trusted for the care provided to their patients
Risks and Complications
- Infection: Signs include fever, redness, and swelling at the incision site.
- Bleeding: The liver has a rich blood supply, and there is a risk of significant bleeding during and after surgery.
- Liver Dysfunction: Temporary or permanent impairment of liver function.
- Bile Leak: Leakage of bile from the liver or bile ducts.
- Blood Clots: Risk of deep vein thrombosis (DVT) or pulmonary embolism (PE).
- Recurrence of Cancer: Regular follow-up is necessary to monitor for any recurrence of cancer.
When to Seek Medical Attention
- Severe abdominal pain that does not improve with pain medication.
- Signs of infection such as fever, redness, or discharge at the incision site.
- Jaundice (yellowing of the skin or eyes).
- Persistent nausea or vomiting.
- Swelling or significant changes around the incision site.
- Difficulty breathing or chest pain (signs of blood clots).
Long-term Management
- Healthy Lifestyle: Maintaining a balanced diet, avoiding alcohol, and staying active to support overall health and liver function.
- Regular Monitoring: Ongoing imaging and blood tests to monitor liver health and detect any recurrence of disease.
- Liver Health: Managing underlying liver conditions and avoiding substances that can harm the liver.
Liver Lesion
Liver Lesions: Patient Information
Liver lesions are abnormal growths or areas of damage in the liver. They can be benign (non-cancerous) or malignant (cancerous).
The liver is a vital organ that plays a crucial role in detoxifying the body, producing bile for digestion, and storing nutrients.
Types of Liver Lesions
- Benign Liver Lesions:
- Haemangioma: A common, benign blood vessel tumour.
- Hepatic Adenoma: A rare, benign tumour often associated with the use of oral contraceptives or anabolic steroids.
- Focal Nodular Hyperplasia (FNH): A benign growth often found in young women.
- Cysts: Fluid-filled sacs that are usually benign.
- Malignant Liver Lesions:
- Hepatocellular Carcinoma (HCC): The most common type of primary liver cancer, often associated with chronic liver diseases like hepatitis and cirrhosis.
- Cholangiocarcinoma: Cancer that forms in the bile ducts.
- Metastatic Liver Cancer: Cancer that has spread to the liver from other parts of the body, such as the colon, breast, or lung.
Causes and Risk Factors
- Chronic Liver Diseases: Hepatitis B and C, cirrhosis, non-alcoholic fatty liver disease (NAFLD).
- Genetic Conditions: Hemochromatosis, Wilson’s disease.
- Lifestyle Factors: Alcohol abuse, obesity.
- Medications: Long-term use of oral contraceptives or anabolic steroids.
- Family History: Genetic predisposition to liver conditions.
Symptoms
- Asymptomatic: Many liver lesions are found incidentally during imaging tests for other conditions.
- Abdominal Pain: Especially in the upper right quadrant.
- Swelling: Abdominal swelling or a palpable mass.
- Jaundice: Yellowing of the skin and eyes.
- Unexplained Weight Loss: Significant weight loss without trying.
- Fatigue: Persistent tiredness and weakness.
- Nausea and Vomiting: Especially if the lesion affects liver function.
Diagnosis
- Imaging Tests:
- Ultrasound: Often the first imaging test to detect liver lesions.
- CT Scan: Provides detailed cross-sectional images of the liver.
- MRI: Offers detailed images and helps distinguish between different types of lesions.
- PET Scan: Used to detect cancer spread.
- Blood Tests:
- Liver Function Tests (LFTs): Assess the liver’s overall function.
- Tumour Markers: Alpha-fetoprotein (AFP) for HCC, CA 19-9 for cholangiocarcinoma, CEA for metastatic colon cancer.
- Biopsy: A sample of liver tissue is taken for microscopic examination to determine if a lesion is benign or malignant.
Treatment Options
Benign Lesions
- Observation: Many benign lesions do not require treatment and are monitored for changes.
- Surgery: If the lesion causes symptoms or complications, surgical removal may be necessary.
Malignant Lesions
- Surgery: Surgical resection of the tumour, often the best option for early-stage cancer.
- Liver Transplant: For certain cases of HCC or other extensive liver diseases.
- Ablation Therapy: Techniques like radiofrequency ablation (RFA) or microwave ablation to destroy cancer cells.
- Embolization: Transarterial chemoembolization (TACE) or radioembolization to block blood supply to the tumour.
- Radiation Therapy: External beam radiation or selective internal radiation therapy (SIRT).
- Chemotherapy: Systemic chemotherapy or targeted drugs like sorafenib for advanced HCC.
- Immunotherapy: Drugs that help the immune system attack cancer cells, such as nivolumab.
Trusted for care
Dr Wang and his team are respected and trusted for the care provided to their patients
Follow-Up Care
- Regular Monitoring: Follow-up imaging and blood tests to monitor for recurrence or new lesions.
- Liver Health: Managing underlying liver conditions and maintaining liver health.
- Lifestyle Changes: Avoiding alcohol, maintaining a healthy weight, and following a balanced diet.
When to Seek Medical Attention
- New or worsening symptoms such as severe abdominal pain, jaundice, or unexplained weight loss.
- Symptoms of liver dysfunction, such as confusion or easy bruising.
- Signs of infection at a biopsy site, including fever, redness, or swelling.
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