Hepatectomy, resection of liver; total right lobectomy
CPT4 code
Name of the Procedure:
Hepatectomy, Resection of Liver; Total Right Lobectomy
Summary
A total right lobectomy is a surgical procedure that involves the removal of the entire right lobe of the liver. This is typically executed to treat various liver diseases, including cancer, tumors, or severe liver injury.
Purpose
The primary purpose of this procedure is to remove diseased or damaged liver tissue. The expected outcome is to eliminate a source of disease, such as a tumor, and to prevent the possible spread of liver disease to other parts of the body.
Indications
- Liver cancer or metastases confined to the right lobe
- Hepatocellular carcinoma (HCC)
- Benign liver tumors causing symptoms
- Severe trauma or liver injury localized to the right lobe
- Certain cases of liver abscess or cysts
Preparation
- Pre-procedure fasting (usually 8-12 hours before surgery)
- Discontinuation of certain medications as advised by the physician
- Blood tests, liver function tests, imaging (e.g., MRI, CT scans)
- Pre-operative clearance from a cardiologist or internist, if needed
- Consent forms and discussion regarding the procedure and potential risks
Procedure Description
- The patient is placed under general anesthesia.
- An incision is made in the abdomen to access the liver.
- The surgeon carefully detaches the right lobe from blood vessels, bile ducts, and surrounding tissue using surgical instruments.
- The right lobe is removed, and any bleeding is controlled.
- The remaining liver tissue and associated structures are checked for stability.
- The incision is closed using sutures or staples.
Common tools and equipment include scalpels, retractors, clamps, and possibly laparoscopic surgical instruments. General anesthesia is administered to ensure the patient is asleep and pain-free during the surgery.
Duration
The procedure typically takes 3 to 6 hours, depending on the complexity and any unforeseen circumstances.
Setting
The procedure is performed in a hospital operating room equipped with advanced surgical facilities.
Personnel
- Surgeons specializing in hepatobiliary surgery
- Anesthesiologists
- Surgical nurses
- Operating room technicians
- Possibly a critical care team for post-operative care
Risks and Complications
- Infection
- Bleeding
- Blood clots
- Bile leakage
- Liver failure
- Adverse reactions to anesthesia
- Injury to surrounding organs
Management of complications includes antibiotics for infections, blood transfusions for bleeding, and additional surgeries if necessary.
Benefits
- Removal of diseased liver tissue
- Potential cure or control of liver cancer
- Prevention of disease spread
- Improvement in symptoms related to liver dysfunction
Patients may begin to notice benefits within weeks to months post-surgery.
Recovery
- Post-operative ICU care for monitoring
- Pain management through medications
- Gradual resumption of eating and physical activity
- Avoiding heavy lifting and strenuous activity for several weeks
- Follow-up appointments to monitor liver function and overall recovery
Typical recovery time ranges from 6 to 12 weeks.
Alternatives
- Partial hepatectomy (removal of a smaller portion of the liver)
- Liver transplantation in the case of widespread liver disease
- Ablative therapies (e.g., radiofrequency ablation)
- Chemotherapy or radiation therapy
Each alternative has its pros and cons, and suitability depends on the patient’s specific condition and overall health.
Patient Experience
During the procedure, the patient will be under anesthesia and will not feel any pain. Post-operatively, patients may experience pain, nausea, and fatigue, which are managed through medications and supportive care. Most patients can return to normal activities gradually, with ongoing monitoring and support from healthcare teams.