Hepatectomy: Surgical Removal of the Liver
What is Hepatectomy?
Hepatectomy is a surgical operation that involves the total or partial removal of the liver. It may be necessary to treat various medical conditions such as liver tumors, metastases from other cancers, traumatic injuries, or chronic diseases like cirrhosis. Depending on the extent of the removal, hepatectomy has different categories, including lobectomy, segmental resection, and total hepatectomy, which involves liver transplantation.
Causes for Hepatectomy
Hepatectomy is commonly recommended for the treatment of Hepatocellular Carcinoma, one of the most common primary liver tumors. Other parameters include the treatment of liver metastases from colorectal cancer and metastases from other gastrointestinal neoplasms. Colon and rectal cancer is associated with liver metastases at a frequency ranging from 25% to 50%. Surgical removal compared to systemic chemotherapy alone for liver metastases has been shown to significantly prolong long-term survival.
How Hepatectomy is Performed and Surgical Procedures Used
Hepatectomy can be performed using different surgical approaches depending on the size and location of the lesion, as well as the patient’s overall condition. Currently, laparoscopic and robotic surgery are increasingly used to reduce the invasiveness of the operation, significantly reducing recovery times and postoperative complications. It is crucial to ensure that the remaining liver volume is sufficient to maintain vital functions. This is particularly important in patients with cirrhosis, where regenerative capacity is compromised.
Risks and Complications
Like any major surgical intervention, hepatectomy presents several potential risks and complications. Some of these include wound infection, liver failure, bile leaks, fat embolism, ascites, and pleural effusions. Liver failure is one of the most concerning complications and can occur in both cirrhotic and non-cirrhotic patients, especially when a large portion of the liver is removed.
The main measure for managing these complications is the rigorous and regular monitoring of liver and kidney function, intravenous infusion of albumin, diuretic medication, and drainage interventions for accumulated fluids.
Hepatectomy is a significant surgical procedure for treating liver cancer and liver metastases, representing the best chance for patient survival. Although it carries high risks due to its complexity, surgical techniques and postoperative care have shown improving results. It is crucial to plan care in a specialized clinic with a multidisciplinary team of medical professionals and healthcare staff.
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