Liver Surgery

Liver abscess:
   Collection of pus in the liver is a common occurrence especially in alcoholics needing antibiotics and anti-amoebics and repeated aspiration by pushing a needle into it under ultrasound guidance. Some large abscesses located in inaccessible areas of the liver, multiple abscesses and those threatening to rupture will require surgical intervention. Most of these abscess can be tackled by minimal access surgery namely laparoscopy and they recover very early and very well. An occasional patient may require opening of the abdomen and draining the pus.

Liver cyst:
Simple cysts: Cysts of the liver are well encapsulated fluid collections. Most simple cysts are congenital and get noticed only when they cause symptoms. Dull ache is the usual presentation. They can usually be treated without surgery. Rarely surgery becomes necessary in the form of deroofing of the cyst. Polycystic liver disease is another uncommon condition and can be associated with polycystic kidney and sometimes pancreatic disease. Large symptomatic cysts require laparoscopic puncture from time to time.

Hydatid cysts of the liver: Common liver affliction in India, hydatid cyst is a parasitic disease caused by a certain tape worm carried by domestic dogs. Unlike simple cysts these are active cysts and keep growing. Majority of these cysts will require surgical treatment either by laparoscopic or open methods. The treatment for these cysts is either a marsupialisation or a cysto-pericystectomy. Spillage of cyst contents can sometimes cause anaphylactic reaction and occasionally dissemination of hydatid disease.

Liver cancer:
Cancer of the liver is a dreaded condition affecting both young and the old. Primary cancers of the liver originate denovo in the liver and a cirrhotic liver damaged by viruses or alcohol is prone to germinating cancer in its cells.
Most cancers from different digestive organs in the abdomen spread to the liver causing secondary deposits. Secondary cancer deposits from colon cancer are amenable to liver resection.

Liver injury:
Patients with injury to the liver often benefit from laparoscopy to evaluate the extent of the injury and decide on opening the abdomen for a definitive surgery.