Regional Hepato-Pancreatico-Biliary Unit - Surrey and Sussex

Associated sites:   Liver.co.uk,    Liver.org.uk,   Bowel-cancer.com

Types of Surgical Operations 

The objective of these pages, examples and images is to show that both segmental and major hepatic resection may be accomplished with minimal blood loss and certainly without transfusion in most situations. 

Segmental Liver Resections

This patient had an cancer of the sigmoid colon removed and at the time of operation was noted to have a secondary tumour in segment 4 of the liver. Figure 1A is an MRI scan showing a solitary secondary deposit located in segment 4 of the liver. Following large bowel surgery the liver tumour was properly staged and 3 months later she was referred for a liver resection. Figure 1B shows a bloodless excision of Segment 4 of the liver. Figure 1C shows the operative specimen with a tumour nodule in the middle, fully excised with 11mm clearance at the closest point.

1A             1B             1C

Major Anatomical Resection

This patient had a primary colon cancer removed 2 years previously. On follow up CT scanning she was found to have a large tumour in the right liver. This was removed by a right hemi-hepatectomy following which she was discharged 8 days later. Figure 2A shows the residual left hemi-liver at operation and Figures 2B and C show the operative specimen before and after sectioning to ascertain the operative margins.