Patients with chronic hepatitis and cirrhosis are at high risk when an
hepatectomy is performed. There are always risks with any surgery, but a
hepatectomy that removes 25 - 60% of the liver carries more than the average risk.
Pain, bleeding, infection, and/or injury to other areas in the abdomen, as well
as death, are potential risks.
Other risks include postoperative fevers,
pneumonia, and urinary tract infection. Patients who undergo any type of
abdominal surgery are also at risk to form blood clots in their legs. These
blood clots can break free and move through the heart to the lungs. In the
lungs, the blood clot may cause a serious problem called pulmonary embolism, a
condition usually treated with blood-thinning medication. But in some cases,
embolisms can cause death. There are special devices used to keep blood flowing
through the legs during surgery to try to prevent clot formation.
There are also risks that are specific only to liver surgery. During the
preoperative evaluation, the treatment team tries to evaluate the patients
liver so that they can decide what piece can safely be removed. Removal of a
portion of the liver may cause the remaining liver to work poorly for a short
period of time. The remaining part of the liver will begin to grow back within a
few weeks and will improve. However, a patient may develop liver failure.
Normal results The results of a hepactetomy are considered normal when
liver function resumes following a partial hepatectomy, or when the transplant
liver starts functioning in the case of a total hepatectomy.
Morbidity and mortality rates Liver cancer may be cured by hepatectomy,
althoughsurgery is the treatment of choice for only a small fractionof patients
with localized disease. Prognosis depends on the extent of the cancer and of
liver function impairment. According to the NCI, five-year survival rates are
very low in the United States, usually less than 10%.
Non-Hispanic white
men and women have the lowest incidence of and mortality rates for primary liver
cancer. Rates in the black and Hispanic populations are roughly twice as high as
the rates in whites. The highest incidence rate is in Vietnamese men (41.8 per
100,000), probably reflecting risks associated with the high prevalence of viral
hepatitis infections in their homeland. Other Asian-American groups also have
liver cancer incidence and mortality rates several times higher than the white
population.
Alternatives There are no alternatives because hepatectomies are performed
when liver cancer does not respond to other treatments.
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