Functions of the Liver

The liver is a major organ that lies in the abdomen just beneath the ribs on the right side. It weighs around 1500 g and its major functions include

  1. Production of bile, which breaks down your food components into nutrients for absorption

  2. Converts the absorbed nutrients into various forms of energy

  3. Produces many hormones and vital proteins essential for the body

  4. Cleans up toxins present in your blood arising from metabolism and medications

  5. Helps control metabolism of fat and production of cholesterol

  6. Production of proteins essential for blood clotting

Liver Surgery

Liver surgery comprises various operations of the liver for different disorders. The most common operation performed on the liver is a resection (removal of a portion of the liver). The most typical indication for liver resection is a malignant tumor. Tumors can be primary (developed in the liver) or metastatic (developed in another organ, then migrated to the liver). The majority of liver metastases come from the colon.

Benign tumors of the liver (cyst, adenoma, hemangioma) can be successfully managed by liver resection as well. If the location of a benign tumor is superficial and small in size, the operation can be performed laparoscopically (by making small punctures in the abdomen while viewing through a video camera).Even large tumours limited to a specific segment are removed by laparoscopy in well selected patients.

A liver resection takes approximately 3-5 hours and can be performed without the need for blood transfusion. Up to 75% of the liver tissue can be safely removed. Liver resections are performed under carefully monitored general anesthesia. There are a variety of tehnological advances that help the surgeon perform a liver resection like harmonic scalpel, water jet dissector, CUSA, and a variety of hemostatic agents. The hospital stay is about 5 -10 days and complete recovery occurs in 3-4 weeks. The resected liver regenerates to its preoperative size in 4 -6 weeks. Excellent results from liver resections are usually achieved in expert hands.

Liver resection patients are carefully evaluated by a multidisciplinary team to ensure the absence of the extrahepatic (outside the liver) tumor. They are also tested to look for the status of the liver function tests, their general physical fitness level to tolerate a major operation and the presence or absence of other conditions like hypertension, diabetes mellitus etc..and once they are deemed fit, they are prepared for surgery.

Possible risks and side effects:

Liver resection is a major, serious operation that should only be done by skilled and experienced surgeons. Because people with liver cancer usually have other liver problems besides the cancer, surgeons have to remove enough of the liver to try to get all of the cancer, yet leave enough behind for the liver to function adequately.

A lot of blood passes through the liver, and bleeding after surgery is a major concern.

Other possible problems are similar to those seen with other major surgeries and can include infections, complications from anesthesia, blood clots, and pneumonia.

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