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Liver ResectionConditions
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Liver resection is recommended to treat various types of liver disease such as both benign and malignant. This surgery is used for the following common benign conditions:
In multispecialty centers, hepatic resections are performed by expert hepatobiliary surgeons who are specially trained for such surgical management.
Hepatic Resection, Hepatectomy
Liver
Several techniques can be used to perform the surgery.
The technique involves crushing the portion of the liver that has to be removed by a surgeon’s finger or surgical clamp (“crush-clamp”).
Liver resection is performed using ultrasound that involves low blood loss and a low chance of bile leak.
This technique applies radiofrequency energy to thermocoagulate the liver parenchyma that later helps in resection by a scalpel.
The method uses a high-pressure water jet to break apart the liver tissue and selectively remove the unwanted portions with minimal blood loss.
This is an alternative to the crush-clamp technique. In this method, a vascular stapler is used to make the procedure faster with less blood loss and no requirement of transfusion.
In recent times, minimally invasive techniques such as total laparoscopic, hand-assisted laparoscopic, and robotic-assisted surgery have gained popularity due to their better outcome, shorter hospital stays, and fewer postoperative complications.
Considerations and corrections of the following factors are primarily required for patients undergoing hepatic resection:
The following blood tests for liver function are performed:
In some special disease-specific cases, tests such as the indocyanine green retention test (ICG R15) is required to predict surgical outcome.
Surgery, noninvasive surgery
An emergency follow-up is required for the following cases:
Normally, follow-up visits are scheduled every 3 to 6 months for 2 years, then every 6 to 12 months as the highest chance of recurrence is within 2 years.
During the check-up, besides physical examinations, doctors may perform the following tests:
Some rare postoperative complications involved with hepatectomy are
In present times, the evolution of modern surgical techniques, new ways of controlling bleeding, and better in-patient care has improved the perioperative outcome.
Patients need to spend 5–10 days or a maximum of three weeks in the hospital after hepatectomy. If laparoscopy is performed, the recovery time is shorter and the patient can return to daily activities within a week. Drips and drains are removed before they leave the hospital.
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