What Is a Hepatectomy?

Hepatectomy is a local liver lesion, including liver tumors, liver trauma, liver abscess, intrahepatic bile duct stones, liver cysts, etc., using surgical techniques to perform liver segment, hepatic lobe and hepatectomy, while retaining sufficient function Normal liver tissue. The liver has rich blood flow, and effective bleeding control during surgery is the key to successful liver resection. According to the methods of controlling liver bleeding, it is divided into two types: regular and irregular. Current liver resections include liver wedge resection, partial liver resection, lobectomy, hepatectomy, mid-hepatic lobectomy, and hepatectomy. Common complications after liver resection include bleeding, liver failure, bile fistula, and infection. Active prevention and correct management of complications after surgery is an important part of reducing surgical mortality. ^[1]

Basic Information

Chinese name

Liver resection

Visiting department

General surgery

Anesthesia

general anesthesia

Preparation for liver resection

(1) Ask detailed medical history and conduct a comprehensive and systematic medical examination of patients.

(2) Liver function test.

(3) Based on the results of the preoperative examination and a comprehensive evaluation of the patient's general condition and liver function examination.

(4) For those with low plasma protein, an appropriate amount of plasma or albumin should be supplemented.

(5) Antibiotics were given within 1 to 2 days before surgery.

(6) Prepare the skin one day before the operation and place the gastric tube in the morning.

(7) Prepare whole blood according to the scope of liver resection.

Indications for liver resection

Malignant tumor of the liver, benign tumor of the liver, intrahepatic bile duct stones, liver trauma, liver abscess, liver cyst, liver hydatid disease

Contraindications to liver resection

1. With comorbid bacteremia and septic shock.

2. Advanced cases.

3. Those who cannot tolerate surgery.

Liver resection procedure

The general steps of surgery: choose the appropriate incision. According to the location and size of the lesion, free the ligaments around the liver. The liver parenchyma was cut bluntly. suture the liver section. The section is covered with omentum, and drainage is placed below.

Postoperative complications after liver resection

Bleeding, liver failure, submental infection, bile fistula, pleural effusion, etc.

Nursing after liver resection

1. According to major abdominal surgery and anesthesia treatment.

2. After 2 to 3 days of postoperative fasting, gastrointestinal decompression, and oxygen inhalation within 24 hours.

3. Continue using antibiotics to prevent infection.

4. Daily glucose infusion and normal saline during fasting to maintain water and electrolyte and acid-base balance.

5. Daily intramuscular or intravenous infusion of vitamins B, C and K.

6. For patients with more than half of the liver removed or with liver cirrhosis, in addition to actively enhancing liver protection after surgery, plasma and albumin should be supplemented within 2 weeks after surgery.

7. Keep the abdominal cavity draining.

8. Give appropriate analgesics after surgery, and encourage patients to expectorate and early activities.

9. Remove skin incision sutures 8-10 days after surgery.

Hepatectomy considerations

He should be reviewed regularly after discharge, including liver function and B-ultrasound. Patients with liver cancer should adhere to liver protection and drug anti-cancer treatment for a long time after surgery. Reexamination of liver function, B-ultrasound, AFP and alpha-fetoprotein heterosomes every 3 months after surgery can detect early recurrence and get timely treatment.

Diet after liver resection

After 2 to 3 days of postoperative fasting, intestinal function was restored and a low-fat, high-sugar, high-vitamin diet was taken. The advanced liquid diet was gradually changed to a semi-liquid diet in the future.