Hepatectomy is the surgical removal of a small portion of the liver or the entire liver. The transplantation of a healthy liver requires the removal of the whole liver; hence, total hepatectomy is performed in such cases. In patients with limited damage to the liver because of cancer, parasitic cysts, or other conditions, partial hepatectomy is performed. Due to the regeneration capacity of the liver, the removed part regrows.
Alternate Name For Hepatectomy
A partial or entire liver
How Hepatectomy is performed?
Anatomically, the liver can be divided into the right lobe and the left lobe. Each lobe has segments, and each component has its bile duct, vein, and artery.
In wedge resections, the affected part of the liver is removed with a small number of normal tissues. A tiny camera is inserted in the liver through a small incision made in the abdominal wall in laparoscopic surgery. The diseased part is removed under the guidance of a laparoscope.
In partial hepatectomy, an incision is made in the middle of the abdomen and under the ribs. Liver ligaments are divided to mobilize the liver. The arteries, veins, and bile duct of the diseased part are identified and resected. Then, the diseased portion of the liver is removed.
In partial hepatectomy, 60% of the liver is removed with minimal injury to the blood vessels and bile ducts. It helps in the regeneration of the liver.
Preparation of Hepatectomy Surgery
- If hepatectomy is performed under general anaesthesia, the preparation for the procedure includes no food or drink consumption for 6-8 hours before anaesthesia.
- Blood tests like haemoglobin, white blood cell count, and kidney function test as well as liver-specific tests like liver function tests, alpha-fetoprotein, and blood clotting tests are advised before the procedure.
- Advanced tests like MRI, CT scan, and PET help know the extent of a healthy liver.
Follow-ups after patient discharge are scheduled after four weeks, followed by 3 to 6 months for two years and 6-12 months after two years of the procedure.
During the follow-ups, the health care professional will analyze the recovery after treatment and look for potential side effects. The follow-ups include a physical examination to check for enlarged liver or spleen as well as oedema, ascites, and jaundice.
Advanced tests like CT scans and MRI are advisable to check for cancer recurrence. A liver function test helps understand the recovery level and liver regeneration in the body.
Risks For Hepatectomy Surgery
Hepatectomy is a safe procedure but rarely can be associated with a few risks like:
- Infections after surgery
- Postoperative pain
- Accumulation of fluid in the abdomen
- Leakage of bile because of damage to the bile duct during surgery
- Filling of liquid in pleural space around lungs
- Uncontrolled and excessive bleeding
- Pulmonary embolism because of immobility for prolonged durations
- Liver failure occurs in patients with chronic liver disease
- Injury to intestine
Recovery From hepatectomy Surgery
Recovery time after laparoscopy is short; patients who undergo an open surgery recover in approximately three weeks. Further, the patients are observed in the intensive care unit for 24-48 hours. Blood tests and ultrasounds monitor the resected liver during the early recovery phase. The liver function tests are repeated to ensure adequate recovery.
During the third day, the patient’s condition can be more stable. The patient might require a cannula for fluid and drug delivery and a urinary catheter. As the condition improves, the health care professional removes these tubes. The patient is then shifted to the recovery room and monitored for liver function tests. The patient is also advised to start moving slowly.