72-year-old patient was acutely diabetic and had history of chronic alcohol intake for the past 40 years got new lease of life at KMC Hospital by a multi-disciplinary team of doctors from Surgical Oncology– Dr Harish E, Dr Jayatheertha, Dr Karthik K S, Dr Gokulnath, Gastroenterologist – Dr Suresh Shenoy, Dr B V Tantry, Dr Sandeep Gopal, Dr Anurag Shetty, Anaesthiology- Dr Ramamurthy Rao and Endocrinologist Dr Srinath Shetty.
Patient was refused surgery in multiple hospitals and later visited KMC Mangalore where further evaluation revealed hepatocellular carcinoma (unifocal). Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and occurs most often in people with chronic liver diseases, such as cirrhosis caused by hepatitis B or hepatitis C infection.
Hepatectomy surgical resection (removal of all or part) of the liver was performed with the help of multimodal treatment involving surgical oncologist, medical gastroenterologist, critical care specialist and anesthetist. Doctors removed 10 x 10 x 8 cm3 mass from left lobe of liver and the surgery went on well. Patient recovery was good and he is now leading a healthy life.
We observe a significant increase in patients with cirrhosis and portal hypertension needing liver resections for primary or metastatic cancers. Liver transplantation (LT) is the causal therapy for patients diagnosed with portal hypertension and advanced liver cirrhosis. However, not all cirrhotic patients are candidates for LT. However, due to ongoing improvements in surgical technique and intensive care management, surgery is feasible in selected patients with adequate long-term outcome. Extended liver resections in patients with underlying hepatic cirrhosis and portal hypertension still represent a medical challenge with regard to perioperative morbidity, surgical management and postoperative outcome. Liver resection needs lot or precision as doctor has to be careful while performing this to restrict blood loss and therefore this requires a multi-disciplinary team approach.