This blog is published for those patients and their families who are delivering effective healthcare services to the primary and the secondary sector. The bedded facilities are being provided to the people.

How has the doctor’s journey been so tremendous?

The years of hard work in this field have led the doctor to do maximum liver transplants in the state. If talking about the statistics, then out of 30, 28 liver transplants have been done in the state. It is because of Dr Hardev Ramandeep Singh Girn that interventional radiology services have begun in the state with the efforts of dedicated and skilled doctors.

Which challenge is emerging in Punjab to set up cadaveric transplantation?

The lack of the political will to establish cadaveric transplantation is one of the issues that is persisting in the state of Punjab. This is emerging as the biggest hurdle in the development of liver surgery in Punjab.

What exactly are the liver transplant hubs?

The experiences which we gain from all the regions of the world are making us understand that the liver transplant units are the best learning stations for liver resection.

How many cases encountered in the SPS hospital are from patient to patient referral?

It has been found out that 90% of the cases are encountered based on direct patient-to-patient referral. The patients go for the resectional surgeries at our hospital, only if the majority have advanced diseases at the time of the presentation.

Which are the commonly asked questions by the patients about the liver and its problem?

These questions are particularly asked by the patients of Punjab. So let us begin:

• Can liver surgery be possible in Punjab?
• Does Liver cancer only get treated with medications?
• Can liver surgery be done by taking both the keyhole and open approach into account?
• Is robotic surgery also available for treating liver problems?
• Which approach is better to treat Liver cancer – Keyhole or Open?
• Is biopsy important for all types of liver cancer?
• How many portions of the liver is to be removed if resections are to be carried out?
• Do the liver resections only take into account if the cancer is to be treated?
• What is cirrhosis?
• For how long will you have to stay in the hospital when you are getting treatment for liver cancer?
• Which precautionary or preventative measures should the patient follow in the future?

How much of the liver can be safely removed?

About 70 % of the liver can be effectively and safely eliminated from the body without causing the patient to encounter any kind of complications. At our hospital, we never treat the patient with the one size fits all approach. Before carrying out the liver procedure, we make sure that the feasibility of the liver which is to be eliminated, must match or get balanced with the following;

• Indications of the procedure
• Indication of the Procedure
• Background preoperative status of the liver
• Anatomy of the inflow/outflow
• Biliary system of the individual
• Functional status of the patient

What is the meaning of the complete hepatectomy?

By complete hepatectomy, we mean removing the whole of the liver. This is usually done when the disease of the cirrhotic liver is to be replaced with the healthy liver. So when the transplantation is to be done, then the whole liver is to be removed.

What do we mean by the partial hepatectomy?

When only the part or a bit of the liver is to be removed, then it is known as the partial hepatectomy. This approach is useful for those patients who are afflicted with the tumor or the cancers which are found in the following parts:

• Gallbladder
• Biliary System

What is the mechanism of the liver?

The liver has an inflow and the outflow from the veins. It helps to make sure that the blood is not going back to the heart and getting collected in the bile. Usually, the blood from the intestines is designed to go to the heart through the liver back. This channelization of the blood is known as the portal vein which is one of the huge sources of transporting the blood to the liver.

Which technique is emerging as the successful technique to carry out the resections?

The resections are usually carried out through open techniques which have always remained the gold standard.

Robotic Surgery

This surgery is known to be having a shorter delivery curve for the HPB surgeon who is not used to laparoscopic surgeries. But if we talk about the trained laparoscopic HPB surgeon, then this surgery does not offer the addition in the value in terms of the finances and the economies for the patients and their results.

How to define Liver Cirrhosis in simple terms?

To define it in simple terms, liver cirrhosis is nothing more than the hardening of the liver which happens to owe to the recurrent inflammation of the liver for some time.

What is caused by cirrhosis?

Cirrhosis usually causes inherent obstructions to the blood which is flowing considerably normally. Apart from that, the following conditions are also caused:

• High Pressure in the portal veins
• Increased size of the spleen
• Enlargement of the veins

Usually, 30 to 40% of the liver resectional volume in our hospital and the practices for the cirrhotic resections are carried out in our hospital.

First of all, you should get clear of this point that not all large volume resections require augmentation.

We have also encountered some cases for the large tumors in which the function value which is left after the procedure is not enough to carry out all the functions of the liver.

Bottom Line

With our years of experience, we have been able to gain success in the procedures like PVE, TACE, and TAE. We believe in treating liver cancers with the multimodal approach, so we make sure that our patients are getting rehabilitated with all the important primary and secondary services.