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Liver: lobectomy
Synonym(s): Hepatic lobectomy
Introduction
- Partial lobectomy implies removal of part of a liver lobe with parenchyma divided anywhere except the hilus.
- Complete lobectomy implies removal at the level of the hilus.
- Partial hepatectomy implies removal of more than one lobe at the same surgery.
- Although guidelines for canine patients suggest up to 70% loss can be tolerated, there are no guidelines available for feline patients.
Uses
- Neoplasia Liver: primary hepatic neoplasia.
- Severe trauma Liver: trauma.
- Abscess Abscess.
- Cyst.
- Torsion (extremely rare).
General considerations
- In the cat, the common bile duct and the major pancreatic duct usually fuse before forming a common entry to the small intestine at the major duodenal papilla.
- Congenital anomalies of the biliary tract are not uncommon in cats - up to 12% incidence - including duplicate gall bladder, divided gall bladder and multiple ductular bladders with one gallbladder. The majority of these are not of clincal significance and do not require intervention if noted at surgery.
- If the hepatic disease has caused biliary obstruction Bile duct: disease, cats with prolonged biliary obstruction are at risk for coagulopathic problems due to malabsorption of vitamin K.
- Many cats with liver tumors not infrequently have pre-operative azotemia Azotemia; this must be taken into account for anesthetic and perioperative management.
Requirements
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Preparation
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Technique
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Aftercare
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Pavia P R, Kovak-McClaren J & Lamb K (2014) Outcome following liver lobectomy using thoracoabdominal staplers in cats. JSAP 55 (1), 22-27 PubMed.
- Sergeeff J S, Armstrong P J, Bunch S E (2004) Hepatic abscesses in cats: 14 cases (1985-2002). JVIM 18 (3), 295-300 PubMed.
- Trout N J, Berg R J, McMillan M C et al (1995) Surgical treatment of hepatobiliary cystadenomas in cats - five cases (1988-1993). JAVMA 206 (4), 505-507 PubMed.
- Lawrence H J, Erb H N, Harvey H J (1994) Nonlymphomatous hepatobiliary masses in cats - 41 cases (1972 to 1991). Vet Surg 23 (5), 365-368 PubMed.
Other sources of information
- McClaran J K & Buote N J (2014) Liver and Biliary tract. In: Feline Soft Tissue and General Surgery. Langley-Hobbs S J, Demetriou J L & Ladlow J F (eds), Saunders, Elsevier. pp 345-359.