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Liver Cancer Surgery

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Liver cancer surgery is used to remove cancerous tissues from the liver. Liver cancer is a cancer that affects the liver tissues either from inside the liver or outside the liver or the tubes or ducts connecting the liver with other organs. Liver cancer can also affect the blood supply vessels like arteries and lymph nodes in and around the liver cancer. Liver cancer has the potential to permanently damage the liver. A person simply cannot survive without the liver. Damage to the liver can easily disrupt the whole functioning of the body. This is why patients with liver cancer must go in for early treatment or else risk losing their lives. This is also the reason why high death rates are seen in liver cancer patients and survival without quick treatment is less than a year.

A liver cancer must be diagnosed thoroughly when symptoms such as abdominal pain, cirrhosis of liver in endoscopic examinations and jaundice or yellowing of skin, eyes and urine is seen. Patients with chronic cases of indigestion, abdominal pain, vomiting and blood in urine as well as weight loss must undergo diagnosis for liver cancer. This cancer can be diagnosed using techniques such as liver biopsy, endoscopic examination, physical examination, blood tests, Doppler and ultrasound tests and liver x-ray and MRI (Magnetic Resonance Imaging) tests.

If liver cancer is detected in these tests, the liver cancer is staged and a path of treatment is decided to maximize positive outcome of the treatment. For example initially chemotherapy or radiotherapy routine may be carried out to reduce the size of the tumor. After this a liver cancer surgery is carried out to quickly and efficiently remove the tumor. A few more rounds of chemotherapy or radiotherapy may be applied to ensure that the tumor is removed completely and does not come back. In certain cases such as stage 3 or 4 liver cancer, if the liver is damaged severely, surgery may be carried out to remove the liver completely or partially.

Liver cancer surgery is done in following ways

Surgical resection or hepatectomy: This procedure has been around since 1949 and was first carried out by Ichio Honjo. This procedure is commonly used not only to treat liver cancers but also other liver ailments. An incision is made on the abdomen of the patient. The tumor spot is identified and then removed using surgical instruments. The spot is then resealed back after surgery. Such procedure was complicated initially with risk of infections and took high time to recover. Nowadays, a very small incision is required. An endoscopic tube with cameras is inserted at the spot near the tumor through the hepatic vessels. The doctors can view live images of the tumor. Then using tiny surgical tools the tumor can be removed. This procedure is carried out by surgeons under localized or complete anesthesia.

The risks with procedure are probable after bleeding, infection and in rare cases complete failure of the liver. Patients with cirrhosis and higher damage to the liver such as that from as hepatocellular carcinoma are at risk of recurrence. In many such cases, the resection may fail causing further damage. However, new techniques, expertise and knowledge in field like use of chemoembolization with surgery have greatly improved success rates of the treatment. Often a combination of conventional liver cancer surgery along with radio ablation and cryo-ablation is used to offer better treatment.

Liver transplant: Liver transplant is used when there are no chances of saving the liver. In such cases, liver is seriously damaged and may prove fatal to the patient. Liver transplant procedure involves partial or complete removal of the liver and replacing it with liver of another person. Liver transplant has been around since 1963 and since then techniques have vastly improved with 5 year survival rates above 68% in last decade. Even then it is a formidable and complicated procedure.

Liver transplant procedure starts with selection of donor whose liver is a close match with the patient's liver. Selection involves many factors from blood group to age to general architecture of the liver. Before the transplant the patient may be put on a liver dialysis or artificial liver. Then a hepatectomy is carried out for partial or complete removal of the damaged liver. Similar procedure is carried out on the donor patient. The new liver or liver section is then re attached to the patient. The blood from donor's liver is preserved in a cold storage.

The risks with this procedure are rejection of the liver graft, infections due to immune suppression drugs used in the treatment and complete failure of the liver. To avoid potential risks to the donor, this procedure can also be carried out by using liver donated by organ donors after their death.

Liver transplantation is an extremely costly treatment. It is made difficult by the fact that donors are few and the treatment itself carries huge risks and side effects to the patient.

Liver cancer surgery has thus improved chances of survival for liver cancer patients. It is now being used worldwide as permanent treatment of liver cancer.

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