Hepatectomy, resection of liver; trisegmentectomy
CPT4 code
Name of the Procedure:
Hepatectomy, Resection of Liver; Trisegmentectomy
Common Name: Liver Trisegmentectomy
Technical/Medical Term: Extended Hepatectomy
Summary
A liver trisegmentectomy is a surgical procedure that involves the removal of three segments of the liver. This type of surgery is usually performed to treat various liver diseases, including cancers or large benign tumors, by excising the affected liver tissues.
Purpose
The main goal of a trisegmentectomy is to remove diseased or damaged portions of the liver to improve the patient's health and longevity. This procedure addresses conditions such as liver cancer, large benign tumors, and severe liver injury.
Indications
- Liver cancer (hepatocellular carcinoma)
- Large benign liver tumors
- Metastatic cancer confined to the liver
- Severe liver trauma or injury
- Persistent liver abscesses not responding to other treatments
Preparation
- Fasting for at least 8 hours before surgery
- Stopping certain medications, as advised by the physician
- Blood tests, imaging studies like CT or MRI, and possibly a liver function test
- Preoperative assessment to evaluate the patient's overall health and surgical risk
Procedure Description
- Anesthesia: The patient is given general anesthesia to ensure they are asleep and pain-free during the surgery.
- Incision: The surgeon makes an incision in the abdomen to access the liver.
- Exposing the Liver: The liver is carefully exposed, and the affected segments are identified.
- Clamping and Cutting: Blood vessels and bile ducts supplying the targeted liver segments are clamped and divided.
- Resection: The surgeon removes the three liver segments, ensuring clear surgical margins.
- Bleeding Control: Any bleeding is managed using surgical techniques and equipment.
- Closure: The incision is closed with sutures or staples, and a drain may be placed to remove any excess fluids.
Duration
The procedure typically takes between 3 to 6 hours, depending on the complexity and extent of the tissue being removed.
Setting
The surgery is performed in a hospital operating room equipped for major surgical procedures.
Personnel
- Primary Surgeon (Hepatobiliary or General Surgeon)
- Assistant Surgeons
- Anesthesiologist
- Operating Room Nurses
- Surgical Technologists
Risks and Complications
- Infection
- Bleeding
- Liver failure
- Bile leakage
- Blood clots
- Reactions to anesthesia
- Damage to surrounding organs
Benefits
- Removal of cancerous or damaged liver tissue
- Potentially improved survival rates for liver cancer patients
- Relief from symptoms related to large tumors or liver damage
- Quality of life improvement
Recovery
- Initial hospital stay of 7 to 10 days
- Pain management with medications
- Gradual return to normal activities over 4 to 8 weeks
- Regular follow-up appointments to monitor recovery
- Potential dietary restrictions and lifestyle modifications
Alternatives
- Liver transplant for patients with extensive liver disease
- Ablation techniques like radiofrequency ablation (RFA)
- Transarterial chemoembolization (TACE) for certain cancers
- Palliative care in non-surgical candidates
Patient Experience
During the procedure, the patient will be under general anesthesia and will not feel any pain. Postoperatively, patients may experience discomfort and pain, managed with medications. They will need to follow a recovery plan and attend follow-up visits for optimal healing and monitoring.