Liver Resection
Introduction
Liver resection, also known as hepatectomy, is a surgical procedure for the extirpation of a portion of the liver. It is also a routine treatment method for liver cancer, benign liver tumors and other liver diseases. Surgeons can perform this surgery on the liver, an exceptional organ for regeneration, even when they need to resect proportionally large sections. This article provides a detailed overview of Hepatectomy, its types, procedures, benefits, risks, and associated costs.
What is Liver Resection?
Liver resection is a surgical procedure that entails the sectioning of tissues of the liver that are diseased or injured. This technique can vary from small-piece removal to large-piece resection. Doctors also frequently treat liver tumors, bile duct tumors, and metastases of other malignancies with it.
The surgeons aim to preserve as many healthy liver tissues as possible and to ensure that they completely resect the whole pathological area.
Why is Liver Resection Needed?
Liver resection is performed for several reasons, including:
- Primary Liver Cancer: To remove malignant tumors such as hepatocellular carcinoma (HCC).
- Metastatic Cancer: If cancer metastasizes to the liver from other sites such as colon or lung.
- Benign Liver Tumors: Such as hemangiomas or adenomas, if they cause symptoms.
- Liver Trauma: To manage severe injuries that damage specific liver sections.
- Living Donor Liver Transplantation: Partial Hepatectomy for transplant purposes.
Types of Liver Resection
Surgeons can choose several approaches to Hepatectomy based on the stage of the disease and the location of the tumor:
- Partial Hepatectomy: Removal of a small section of the liver.
- Lobectomy: Complete resection of an entire lobe of the liver (right or left lobe).
- Extended Hepatectomy: Extraction of more than one lobe and/or large parts of the liver.
- Segmentectomy: Removal of specific liver segments based on anatomical landmarks.
- Non-Anatomical Resection: Removal of tumors without following anatomical boundaries.
Procedure Steps
Liver resection is a complex surgical procedure, that must be performed in the operating room, under general anesthesia. The steps typically include:
- Preoperative Assessment: A dried liver specimen and the location of the tumor can be imaged by computerized tomography (CT) or magnetic resonance imaging (MRI).
- Incision: The abdomen is incised to reach the liver, and an incision is made in the abdomen.
- Liver Mobilization: The liver is carefully freed from surrounding tissues.
- Tumor Identification: Surgeons locate the tumor using imaging guidance.
- Resection: Diseased liver tissue is removed using specialized surgical tools.
- Hemostasis: Bleeding is successfully controlled, and the remaining part of the liver is checked for functional normality.
- Closure: The surgical site is closed and the patient is moved to recovery.
Benefits of Liver Resection
The benefits of Hepatectomy include:
- Complete removal of diseased or cancerous tissue.
- Preservation of healthy liver tissue to allow regeneration.
- Improved quality of life and, to a lesser degree, cures of benign tumors.
- Long-term survival for patients with localized liver cancer.
Risks and Complications
Liver resection, as with any major operation, carries risk and associated complications.
- Bleeding during or after surgery.
- Bile leakage from the liver.
- Infection of the surgical site or abdomen.
- Liver failure in patients with pre-existing liver conditions.
- Blood clots or deep vein thrombosis (DVT).
- General complications like anesthesia reactions.
Cost of Hepatectomy
Liver resection costs can vary significantly between India and the USA due to differences in healthcare systems and pricing.
- India: Liver portal vein invasion resection in India usually costs between $5000 and $10000 depending on the hospital and procedure complexity.
- USA: In the USA (as well as in India), the costs can range from $40,000 to $80,000, and as such, India is a cheap destination for medical tourists.
It is possible to have variations in costs due to varying parameters, such as the level of hospital facilities, surgeon’s experience, and postoperative management.
Top Hospitals in India for Hepatectomy
Several highly respected hospitals in India provide liver resection:
- Medanta—The Medicity (Gurugram): Known for advanced liver surgeries and transplant programs.
- Apollo Hospitals (Chennai): Equipped with state-of-the-art facilities and experienced surgeons.
- Fortis Memorial Research Institute (Gurugram): Offers cutting-edge technology and personalized care.
- Global Hospitals (Hyderabad): Specializes in hepatology and liver transplantation.
- Max Super Speciality Hospital (Delhi): Renowned for minimally invasive liver surgeries.
