Liver surgery

What is Liver Surgery?

Liver surgery is one of the most challenging areas of abdominal surgery (visceral surgery). An operation on the liver will always be carried out by a specialised liver surgeon. The liver is the most important organ for detoxification and metabolism in the human body. Unfortunately its function cannot yet be replaced by machines, as in the case of kidney dialysis. Consequently, liver diseases require quick and efficient treatment, which often means an operation.

Which diseases does a liver surgeon treat?

Diseases of the liver can have a variety of causes and take many different forms. Symptoms are often unspecific and only appear when the disease is at a relatively advanced stage.

Liver abscess operation

A liver abscess (accumulation of pus) should be treated not only with antibiotics but also through the removal and flushing of the abscess.

Liver cyst operation

Liver cysts, if congenital, must only be treated if there are symptoms. However, in the case of echinococcosis (infection caused by the dog tapeworm), all affected cysts or lumps should be removed by an abdominal surgeon.

Operating on non-cancerous tumours of the liver

Despite their benign nature, non-cancerous liver tumours should always be operated on, due to the possibility of them degenerating into malignant liver cancer.

Operating on tumours of the liver and gall bladder

Vascular tumours in the liver do not degenerate and therefore must only be treated if extensive growth results in symptoms.

Malignant diseases, like liver cancer (HCC – hepatocellular carcinoma), cancer of the bile duct in the liver (CCC – cholangiocellular carcinoma), or metastases of other types of cancer (liver metastases), should always be completely removed by an experienced visceral surgeon.

Other diseases, like alcohol abuse, cystic fibrosis, hepatitis, or liver tumours, can lead over time to total liver damage. This results in cirrhosis of the liver (the formation of inoperable/ non-functional fibrous tissue in the liver). In such cases, a liver transplant can be the only effective method of treatment.

Which surgical procedures are used in liver surgery?

The scope of liver surgery is very wide, ranging from minimally invasive procedures to the removal of the entire organ. Minimally invasive procedures, for example, the removal of tumours on the periphery of the liver, can be carried out endoscopically, where only a minimal incision in the abdominal wall is needed. In the case of more major disorders or defects, a liver resection is carried out.

The liver can be divided by the vessels which supply it into eight anatomically distinct segments. Each of these segments, and even an entire liver lobe, can be removed, as the remaining tissue is effective enough to supply or to detoxify the body. If a large section of the organ is damaged or diseased, a liver transplant must be carried out. The whole organ or just a section can be transplanted. A living donation is also possible within strict legal limits.

An alternative to surgery in the treatment of tumours is radio frequency ablation. An electrical probe is inserted close to the tumour, visually controlled by means of an x-ray image, and uses heat radiation to destroy it. Tumours of up to 3cm in diameter respond successfully to this method.

The most important indication for gall bladder and bile duct surgery is the presence of gall stones. The main treatment is removal of the gall bladder, an organ which is not essential for humans. This operation can also be done by means of key-hole surgery.

How can I find an experienced specialist for liver surgery?

You clearly want the best medical provision if you need a liver surgeon, which is why it is natural for a patient to wonder: how do I find the best clinic for liver surgery for me? As there is no objective answer to this question, and a serious doctor would never claim to be the best one, you can only rely on the experience of a doctor.

We can help you find an expert for your disease. All listed doctors and clinics have been verified by us as having excellent specialist skills in the area of liver surgery, and await your enquiry or request for treatment.

Sources:

www.dgav.de/arbeitsgemeinschaften/calgp.html