Dr. Fong is the Medical Director of the USC Liver Transplant Program and Associate Professor of Medicine at the USC Keck School of Medicine. He obtained his medical degree from the University of Southern California and completed his residency in Internal Medicine at Los Angeles County-USC Medical Center. He is board certified in Internal Medicine and the subspecialty of Gastroenterology.
Liver resection is the surgical removal of a portion of the liver. This
operation is usually done to remove various types of liver tumors that are
located in the resected portion of the liver. The goal of liver resection is to
completely remove the tumor and the appropriate surrounding liver tissue without
leaving any tumor behind.
Which patients with liver cancer undergo liver
resection?
In patients with liver cancer (Hepatocellular Cancer, HCC), this treatment
option, liver resection, is limited to patients with one or two small (5 cm or
less) and confined to the liver with no invasion of the blood vessels. As a
result of these strict guidelines, in practice, very few patients with HCC can
undergo liver resection. The biggest concern about resection is that following
the operation, the patient can develop liver failure. The liver failure can
occur if the remaining portion of the liver is inadequate (for example, because
of associated cirrhosis) to provide the necessary support for life. Even in
carefully selected patients, about 10% of them are expected to die shortly after
surgery, usually as a result of liver failure.
Liver cancer is the fifth most common cancer in the world and the majority of patients with liver cancer will die within one year as a result. Patients with associated cirrhosis caused by chronic hepatitis B or C infections, alcohol, and hemochromatosis are at the greatest risk of developing liver cancer. Many patients with liver cancer do not develop symptoms until the advanced stages of the tumor which usually makes prognosis poor. The combination of an imaging study (ultrasound, CT, or MRI scans) and an elevated blood level of alpha-fetoprotein will most effectively diagnose liver cancer, while a liver biopsy can make a definitive diagnosis. Medical treatments, including chemotherapy, chemoembolization, ablation, and proton beam therapy, are not very effective. Surgical removal of the tumor or a liver transplant may be most effective in certain cases.
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections. Symptoms include yellowing of the skin, itching, and fatigue.
The liver is the largest solid organ in the body, and is actually an gland. The liver has a wide variety of critical functions such as manufacturing proteins and metabolizing fats and carbohydrates. The liver also eliminates harmful biochemical waste products from the body (alcohol, drugs, toxins). The liver secretes bile that aids in digestion. Examples of diseases of the liver include cirrhosis, hepatitis, cancer, and fatty liver. Symptoms of liver disease include bleeding, easy bruising, edema, fatigue, and jaundice.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
Liver transplantation is considered when the liver no longer functions adequately (liver failure). Liver failure can occur suddenly (acute liver failure) as a result of infection or complications from certain medications or it can be the end result of a long-term problem. The following conditions may result in liver failure:
Chronic hepatitis with cirrhosis.
Primary biliary cirrhosis (a rare condition where the immune system inappropriately attacks and destroys the bile ducts causing liver failure).
Sclerosing cholangitis (scarring and narrowing of the bile ducts inside and outside of the liver causing the backup of bile in the liver which can lead to liver failure).
Biliary atresia (malformation of the bile ducts).
Alcoholism
Wilson's disease (a rare inherited disease with abnormal deposition of copper throughout the body, including the liver, causing it to fail)./l...
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