Liver & Pancreas Surgery

Surgical treatment options for Pancreas disease include:

 

Liver

The liver is situated in the upper right side of the abdominal cavity and is the largest organ in the body, weighing 1200-1600g. The liver has a wide variety of functions, the main functions being the removal of harmful substances from the blood, and production of bile to assist in the digestion of food.

Once the liver has broken down harmful substances, its by-products are excreted into the bile or blood. Bile by-products enter the intestine and ultimately leave the body in the form of faeces. Blood by-products on the other hand are filtered out by the kidneys, and leave the body in the form of urine.

 

Liver Surgery

Liver surgery is most commonly indicated for resection or removal of liver cancer. It may be done laparoscopically (key hole surgery) or by conventional open surgery, depending on the site of the tumour. In Australia, the most common indication is the removal of metastases (secondaries or spread) of bowel cancer. Patients with this condition will often have other treatments such as chemotherapy or radiological procedures as part of the treatment plan.

The next most common indication is hepatocellular cancer (hepatoma, HCC), which is often associated with chronic liver disease such as hepatitis or haemochromatosis. Occasionally, other tumours of the liver such as cholangiocarcinoma (cancer of the bile duct), gallbladder cancer and secondaries from neuroendocrine cancers and melanoma are appropriate for surgical treatment.

There are a number of benign tumours of the liver, most of which can be monitored and do not need to be removed. Up to 70 per cent of a healthy liver can be removed as it will regenerate. In patients with chronic liver disease less can be safely removed.

With the advances in laparoscopic or keyhole surgery, more surgery on the liver is performed in this manner, for smaller and peripheral tumours. Keyhole surgery may enhance quicker recovery and return to full function. Below are common topics related to the liver.

Below are common topics related to the liver.

Liver Cancer :: Hepatomegaly :: Hepatitis :: Hydatid Liver Disease
Cirrhosis :: Liver Biopsy

 

Whipple Procedure

Also known as pancreaticoduodenectomy, it is performed to treat cancers at the head (wide part) of the pancreas. During the procedure, the head of the pancreas, the gallbladder, duodenum, a part of the bile duct, and sometimes a part of the stomach are removed. The remaining bile duct, intestine, and pancreas are then reconnected so that enzymes and bile can flow back into the intestines.

Infection, bleeding, diarrhea, weight loss and diabetes are common surgical complications of this procedure. You will be able to eat small amounts of easily digestible food and may have to take medications to assist digestion.

 

Distal Pancreatectomy

It is usually performed when the cancer is found in the middle or tapering end of the pancreas. This procedure takes less time and has a shorter period of recovery when compared to Whipple procedure.

 

Total Pancreatectomy

A complete resection is opted for when the tumor extends across the pancreas. During the procedure, the entire pancreas, the gallbladder, common bile duct, spleen, and parts of the stomach and small intestine are removed. Following the surgery, the patient loses the ability to create enzymes for digestion and insulin for controlling blood glucose level. Therefore, the patient has to take enzymes and insulin supplements for lifelong.

 

Drainage Procedures

It is performed to open the pancreatic ducts that are blocked due to chronic pancreatic damage. An incision is made from your chest to abdomen, and the pancreas is exposed. The pancreatic duct can be opened from head to tail (Puestow procedure) or transversely at the neck and body (Du Val procedure) and connected to a loop of the small intestine, into which the pancreatic juices drain. The incision is then sutured. Complications associated with this procedure include bleeding and pancreatic fistula (due to leakage).