Institute Of
Gastroenterology
Liver Surgery
Liver abscess
Pus in the liver is prevalent, especially in alcoholics who require antibiotics and anti-amoebic, as well as repeated aspiration with a needle under ultrasound guidance. Surgical intervention is required for big abscesses in inaccessible parts of the liver, multiple abscesses, and those that are threatening to burst. Pyogenic liver abscess, amoebic liver abscess, and fungal liver abscess are the three most common kinds of liver abscess. Needle aspiration, percutaneous catheter drainage, open and laparoscopic surgical drainage are all options for draining liver abscesses.
- Percutaneous needle aspiration: Needle aspiration can be used to recover material for microbiologic and pathologic analysis. Under the supervision of a CT scan and ultrasound, the cavity material is aspirated
- Percutaneous catheter drainage: Small cysts are usually treated with percutaneous catheter drainage. Surgical drainage is preferred for cysts larger than 5 mm, multiloculated cysts, and ruptured cysts. Under CT and ultrasound guidance, a catheter is inserted using Seldinger or trocar methods. Multiple abscesses are drained using this procedure.
- Laparoscopic liver abscess drainage: Under general anaesthesia, a tiny cut is made below the umbilicus. After establishing the pneumoperitoneum, a laparoscope is inserted into the peritoneal cavity. Paracentesis is used to remove pus from the liver.
- Open surgical drainage: After creating a right subcostal or superior median abdominal incision, the area is examined for abdominal lesions. After the liver's position is determined, hemostatic forceps are utilised to enter the cavity and a paracentric needle is used to extract the pus.
Liver cysts
Simple cysts: Liver cysts are fluid collections that are well enclosed. The majority of simple cysts are congenital and cause no symptoms. The majority of the time, they can be handled without surgery. Simple liver cysts, on the other hand, are unroofed when they become large enough to cause symptoms. The section of the wall that extends to the liver’s surface is removed. Large symptomatic cysts may require laparoscopic puncture, however cyst unroofing can also be done laparoscopically.
Polycystic liver disease: Unroofing, fenestration, or excision of the cystic liver are all used to decompress the cystic liver. This procedure is considered only for patients displaying chronic and disabling pain.
Neoplastic cysts: Complete tumour ablation is used to treat cystadenoma and cystadenocarcinoma. Enucleation, fenestration, formal resection, and total fulguration are among procedures that are used.
Hydatid cysts: Hydatid cyst is a parasitic ailment caused by a tape worm carried by domestic dogs and is a common liver affliction in India. Hydatid cysts can be life-threatening if untreated. The majority of these cysts require surgery, such as marsupialization or cysto-pericystectomy. Spillage of cyst contents might result in allergic reactions and hydatid disease spread.
Marsupialization: To make a continuous layer from the exterior to the internal surface, a slit is cut into the abscess and the edges are sewn together. The site can then easily drain.
Cystopericystectomy: Laparoscopic cystopericystectomy is nearly identical to open cystopericystectomy. It is a challenging technique that involves puncturing the cyst and aspirating the fluid to prevent spilling. An open surgery, rather than a laparoscopic operation, allows for better control of this aspect of the procedure.
Liver Cancer
Cancer of the liver is a dreaded condition affecting both young and the old. Primary liver cancer is called hepatocellular carcinoma and can be a congenital defect or even due to scarring of the liver due to alcohol abuse. Most cancers from different digestive organs in the abdomen spread to the liver causing secondary deposits. Secondary cancer deposits from colon cancer are amenable to liver resection. Surgeries for liver cancer include partial hepatectomy, liver resection, lobectomy, and liver transplant. In partial hepatectomy, part of cancer affected liver is removed. In liver resection and lobectomy, the lobe of the liver is removed or an attempt is made to remove cancer surrounding the tissues of the liver.
Liver cancer is a terrifying disease that can strike anyone, young or old. Hepatocellular carcinoma is a type of primary liver cancer that can arise from a congenital defect or scarring of the liver caused by alcohol abuse. The majority of malignancies in the abdomen’s digestive organs travel to the liver, generating secondary deposits. The liver can be resected to remove secondary cancer deposits from colon cancer. Partial hepatectomy, liver resection and lobectomy, and liver transplant are some of the procedures used to treat liver cancer. Part of the cancer-affected liver is removed during partial hepatectomy. The lobe of the liver is removed or an attempt is made to eliminate the malignancy surrounding the hepatic tissues in liver resection and lobectomy.
Liver cancer is a terrifying disease that can strike anyone, young or old. Hepatocellular carcinoma is a type of primary liver cancer that can arise from a congenital defect or scarring of the liver caused by alcohol abuse. The majority of malignancies in the abdomen’s digestive organs travel to the liver, generating secondary deposits. The liver can be resected to remove secondary cancer deposits from colon cancer. Partial hepatectomy, liver resection and lobectomy, and liver transplant are some of the procedures used to treat liver cancer. Part of the cancer-affected liver is removed during partial hepatectomy. The lobe of the liver is removed or an attempt is made to eliminate the malignancy surrounding the hepatic tissues in liver resection and lobectomy.
Liver Injury
Laparoscopy is frequently used to assess the degree of a liver injury and decide whether or not to open the abdomen for definitive surgery.
