Sunday, April 14, 2024

Liver Surgery To Remove Tumor

Surgery For Gastrointestinal Carcinoid Tumors

Laparoscopic liver resection for hepatocellular carcinoma located in segment 7 or 8

Many gastrointestinal carcinoid) tumors can be cured by surgery alone. The type of operation will depend on a number of factors, including the size and location of the tumor, whether the person has any other serious diseases, and whether the tumor is causing the carcinoid syndrome.

Surgeons often try to cure localized carcinoid tumors by removing them completely, which is usually successful.

The options for GI carcinoid tumors that have spread to nearby tissues or to distant parts of the body are more complex. Because most carcinoid tumors grow slowly and some do not cause any symptoms, completely removing all metastatic carcinoid tumors may not always be needed. But in some patients, surgery to remove all visible cancer is the best option. This is particularly true if removing most of the cancer will reduce the level of hormone-like substances causing symptoms.

Several types of operations can be used to treat GI carcinoid tumors. Some of these remove the primary tumor , while others remove or destroy cancer that has spread to other organs.

What Are The Risks Or Complications Of Liver Resection Surgery

Complications may include:

  • Infection. You can get an infection in your incision wound, your urinary tract or your lungs . Your provider treats such infections with antibiotics.
  • Bleeding. Your liver has a lot of blood vessels, and its also responsible for making your blood clot stop bleeding. Liver surgery interferes with this process, so sometimes patients bleed too much. Some may need a blood transfusion after surgery.
  • Bile leakage. Damage to any of the bile ducts in your liver during surgery can cause bile to leak, which may collect inside your abdomen. This may require placing an additional drain.
  • Pleural effusion. After liver surgery, fluid can easily build up inside your chest cage. It can cause chest pain and shortness of breath. It may be treated with medication or may need to be drained.
  • Ascites. Liver surgery can also cause a buildup of fluid in your abdominal cavity. It may be treated with medication or may need to be drained.
  • Deep vein thrombosis. After any surgery, theres a risk of blood clots from being in bed for a long time. Pay attention to any spot on your arms or legs that seems swollen or sore.
  • Kidney failure. Sometimes surgery can cause your kidneys to stop working. It is important to stay well hydrated.
  • Liver failure. If the remaining liver doesnt have enough function left, you can go into liver failure. In this case, you may need an urgent liver transplant.

How Is The Liver Divided Up

The liver can be divided into a right and left lobe. Within each lobe the liver can be divided into segments, based on the division of the blood vessels within the liver. The segments are numbered from one to eight in Roman numerals. The left lobe is composed of segments II IV, while the right lobe is composed of segments V-VIII. From the outside it is not possible to determine the division between the segments. Pre-operatively radiological imaging of the liver is used to define the segmental anatomy, while intra-operatively USS can be used directly on the surface of the liver. The segmental anatomy of the liver provides the basis for determining the plane of transection during liver resections.

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Days Before Your Surgery

Follow Your Healthcare Providers Instructions for Taking Aspirin

If you take aspirin or a medication that contains aspirin, you may need to change your dose or stop taking it 7 days before your surgery. Aspirin can cause bleeding.

Follow your healthcare providers instructions. Do not stop taking aspirin unless they tell you to.

For more information, read Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs , or Vitamin E.

Stop Taking Vitamin E, Multivitamins, Herbal Remedies, and Other Dietary Supplements

Stop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements 7 days before your surgery. These things can cause bleeding.

If your healthcare provider gives you other instructions, follow those instead.

For more information, read Herbal Remedies and Cancer Treatment.

Outcomes Better Than The National Benchmark

Minimally Invasive Treatment of Malignant Hepatic Tumors: At the ...

Liver cancer surgery is highly complex and should be done only by hepatobiliary surgeons with extensive experience. Roswell Park is a high-volume center for both liver and pancreas surgery, and over the last 7 years, the 30-day and in-hospital mortality for both liver and pancreas resection has been less than 3% better than the national average for this important quality measure.

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How Much Pain Will I Experience Post

Most people experience mild to moderate pain, which is readily, controlled using a combination of treatments. The anaesthetist will have a discussion with you prior to the operation regarding how your pain will be controlled. It is our usual practice to combine local nerve blocks with local anaesthetic that is placed at the time of your surgery. Systemic analgesia are then used to supplement this if needed. You will be given patient controlled analgesia post-operatively which allows you to control the administration of the painkillers. Once you are tolerating a reasonable diet, the PCA will be removed and you will be given oral painkillers as required. You will experience some pain/discomfort from your wounds, especially on movement, and you will need to communicate the severity of the discomfort to the medical staff looking after you so that the medication can be optimized to your needs. At the time of discharge you will be given a supply of painkillers and post-operative instructions on what to take when. Usually by day 4 most patients are only requiring minimal analgesia to control their pain.

Liver Surgical Procedures Performed

At St. Josephs Medical Center, we strive to provide with a more favorable outcome through liver cancer surgery than anywhere else. As a result, Dr. Mark Fraiman has become a top-rated surgeon for liver cancer with a stellar success rate.

Liver resection surgery can be challenging because there are numerous blood vessels leading to and from the heart via this organ. Also, the liver can get injured easily, and it tends to bleed a lot. Because we perform hundreds of surgeries each year, we are familiar with the techniques that can minimize loss of blood and eliminate the need for transfusion while undergoing liver surgery to remove a tumor.

Surgery is usually the best type of treatment for early-stage liver cancer that isnt found near major blood vessels. It is also good for when you dont have any other medical conditions, such as liver cirrhosis. Depending on your specific condition, we may use other types of therapy such as chemotherapy before surgery to shrink the tumor first.

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How Serious Is A Liver Resection

Liver resection is considered a technically difficult surgery. One reason is that your liver has many vessels in it and may bleed a lot, so liver surgeons have to be trained in special techniques to not injure the vessels and to manage any bleeding. When your resection is smaller , its less risky and can be done through minimally-invasive surgery techniques, such as laparoscopy or robotic surgery. When you need a major resection , it becomes more dangerous and difficult. As a rule, you want to have your liver resection with experienced specialists because of the complexity of the operation.

What Will Need To Be Done To Care For My Wound

Heroic Hepatectomy: Surgeons Remove Basketball-sized Liver Tumor Slowly Killing Father Of Four

The open operation is usually performed through an incision that is like a reversed L in the right upper quadrant of your abdomen. The skin is re-approximated using dissolvable sutures that do not need to be removed post-operatively. Steri-strips are placed along the incision, and a waterproof dressing is placed over. The dressing will be left undisturbed for at least 3 days postoperatively to try and avoid contamination. You will be able to shower each day as the dressing is waterproof. Once the dressing has been taken down and it appears clean and dry the wound will be left without a dressing and you can shower as normal, taking care not to use any strong soaps or creams around the area. It may be that your wound leaks some darkish fluid or looks a little inflamed. This is not unusual and the staff will observe it closely. Occasionally stitches or staples will be used to close the skin. These will need to be removed after 10 days, and can be done by the district nurse. It is ok to use Bio-oil or Vitamin E on the incisions after the first week to help reduce scar prominence.

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At Home: Recovery Tips

A follow-up visit is required after 10 to 14 days of your discharge. You can recover sooner at home by following these tips:

  • Take pain medications as prescribed and when required. Visit your surgeon if those medications do not reduce your pain.
  • Follow the diet as instructed and do not drink alcohol.
  • Do exercise, especially walking.
  • Make sure to drink 8 glasses of liquids daily.
  • Sometimes the skin below your incision will feel numb, this is normal and will go away over time. If you have any drainage from your incision or if the area around your incision is puffy or red, visit your surgeon.
  • Take a shower every day with warm water.
  • When you are ready to take solid foods, make sure to eat 4 to 6 small meals every day.
  • Do not lift heavy weights for 8 weeks after your surgery.
  • Talk to your surgeon before you get back to work, especially if your work involves lots of heavy lifting or movement.
  • Take a small walk after every hour to prevent blood clots.

Want to learn more about liver surgery? Contact us at 907-276-3676. At Far North Surgery, the doctors have ample experience in performing various types of liver surgeries.

When To Call Your Healthcare Provider

  • You have a fever of 100.5 °F or higher.
  • You have chills.
  • Youre having shortness of breath.
  • The skin around your incision is warmer than normal.
  • The skin around your incision is getting more red.
  • The area around your incision is starting to swell.
  • Swelling around your incision is getting worse.
  • You have pus-like drainage from your incision.
  • You have any sudden increase in pain or new pain.
  • You have nausea and vomiting.
  • You have diarrhea.
  • You have constipation that isnt relieved within 2 days.
  • You have fatigue thats getting in the way of your day-to-day activities or your ability to get out of the house and exercise.
  • You have jaundice .
  • You have any new or unexplained symptoms.
  • You have any questions or concerns.

Contact information

, contact your doctors office.

After 5:00 p.m., during the weekend, and on holidays, call and ask to speak to the doctor on call for your doctor.

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What Happens Before A Liver Resection

Your healthcare provider will need to determine whether surgery is the best option to treat your condition. This may depend on:

  • Whether youre healthy enough to tolerate surgery.
  • Whether the lesion in your liver is technically operable.
  • Whether you have cancer in other parts of your body besides your liver.

In some cases, radiation therapy, interventional radiology or chemotherapy may be done before surgery to reduce the cancer size, make the operation easier and safer, or improve the chance of curing cancer.

Your healthcare provider will also need to decide whether a partial hepatectomy or a liver transplant is needed. This may depend on:

  • How extensive the tumor is.
  • How healthy your liver is.
  • How much functional liver can be left after resection.
  • Whether you qualify for a transplant.

To screen you for these factors, your healthcare provider may want to run some tests, including:

Contact Us For Help With Difficult Liver Cancer Cases

Pin on Transplantation

Our liver specialists are famous for operating on cancers that other hospitals wont try. For instance, Dr. Fraiman is the only East Coast liver surgeon experienced in treating cholangiocarcinoma and among the few in the USA performing Whipple surgery. Hes also lauded as one of the best liver surgeons in Maryland, having received numerous awards and honors.

To get in touch with our liver specialists, please complete our contact form, and we will get back to you as soon as possible.

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Is It True That The Liver Regrows Following Resection

The liver is the only organ in the body that is able to regenerate . This means that when part of the liver is removed, the volume of the remaining liver increases until it returns to the volume of the original whole liver. Bile ducts and blood vessels do not re-grow, rather the remnant liver increases in size. This normally takes up to 8 12 weeks following a major liver resection. Up to 70% of a healthy liver can be removed. However, in the presence of chronic liver disease or chemotherapy, a larger remnant is required, reducing the amount of liver that can be removed.

Recovery From A Liver Resection

Recovery from a liver resection is a lengthy process. Directly after surgery, you will be moved to a Post Anesthesia Care Unit . If you are in severe pain, you may need a patient-controlled analgesia device to help you self-manage your pain. Depending on the complexity of your case, you may need to stay in the PACU overnight. You will be taken to a hospital room after your stay in the PACU. You will not be able to eat for a few days after the surgery. You may need to stay in the hospital for a week or more depending on how well you are recovering.

Before being discharged, your doctor will give you detailed discharge instructions including:

  • Follow-up appointment schedule you typically will have an appointment within one to three weeks after discharge.
  • Pain management options either prescription or OTC pain medication may be advised
  • Nutrition eating a balanced diet that is high in protein can help you recover more quickly
  • When you can resume your activity level after surgery gradually return to your activity level and normal routine
  • When you can drive typically you can drive three weeks after surgery

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Minimally Invasive Liver Resection Surgery

Your team of doctors at the UPMC Liver Cancer Center may recommend minimally invasive liver surgery, over traditional surgery, based on the location and size of the tumors.

As leaders in minimally invasive surgical liver resection, our surgeons can remove certain benign or malignant liver tumors through three or four keyhole-sized incisions.

Chest Wound Urine Infection

Laparoscopic Liver Surgery | UPMC

There is a risk of infection after an operation. The wound area might be red and sore. If you have a chest infection you might have a cough or feel short of breath. You might also feel generally unwell and have a temperature.

Let your doctor or nurse know if you have any symptoms. They can give you antibiotics through a drip or as tablets.

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What Is The Difference Between Laparoscopic/robotic Vs Open Hepatectomy

In open abdominal surgery, one long incision called a laparotomy opens up your abdominal cavity. Surgeons are able to visualize your abdomen directly. Its best suited for more complex procedures.

In laparoscopic surgery, the entire operation takes place through small keyhole incisions while your surgeon looks at the images from the camera on a screen. They use specially designed, long instruments to complete your liver resection. They can also use robotic arms. Movement is somewhat restricted, so surgeons traditionally use a laparoscopic or robotic approach for less complex liver resections. But with the development of surgical techniques, more complex surgeries such as major liver resection or living donor liver resections are now possible through a laparoscopic or robotic approach.

If Treatment Does Not Work

Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and for some people, advanced cancer is difficult to discuss. However, it is important to have open and honest conversations with your doctor and health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.

Patients who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families. Learn more about .

After the death of a loved one, many people need support to help them cope with the loss. Learn more about .

The . It offers more information about research studies that are focused on finding better ways to care for people with cancer. Use the menu to choose a different section to read in this guide.

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Primary And Metastatic Tumor Characteristics

The primary tumor was in the colon in 160 cases and in the rectum in 66 cases . Sixty-three percent of the primary tumors had involved regional lymph nodes, and 89% had well- or moderately-differentiated histology. Liver metastases presented synchronously with the primary tumor in 67 patients and liver resection was performed within 12 months of the primary resection in 107 patients . One hundred and forty-one patients underwent resection for solitary metastases , and 20 patients had 4 or more resected tumors. The median size of the liver tumors was 3.9 cm with 93 patients having tumors larger than 5 cm. In 125 patients, the tumor was located only within the right lobe, and 48 were only within the left lobe. Fifty-four patients had bilobar disease resected. Preoperative CEA was above 100 in 23 of 67 patients . For the entire group, systemic chemotherapy was administered preoperatively in 118 patients .

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