PERIOPERATIVE CHALLENGES IN MAJOR HEPATECTOMY FOR LARGE LIVER TUMOURS: A CASE REPORT
DOI:
https://doi.org/10.65605/a-jmrhs.2026.v04.i01.pp868-873Keywords:
Rare Anatomy of Portal Vein, Being Single with Number of Small Branches to Both Lobes of Liver, Hepatectomy, Liver Tumour, Anaesthesia, Post-Hepatectomy Liver Failure, Hepatic Encephalopathy. Perioperative Management, CVP Monitoring.Abstract
Background: Major hepatic resection for large primary liver tumours presents a constellation of perioperative challenges encompassing haemodynamic management, blood conservation, anaesthetic depth, hepatic functional reserve, and postoperative critical care. We report the successful anaesthetic and surgical management of a 27-year-old female with a massive hepatic mass (12 × 16.7 × 20.8 cm) who underwent left hemi-hepatectomy. Case Summary: The procedure was conducted under general anaesthesia with invasive haemodynamic monitoring. Intraoperative blood loss was minimal. On postoperative day (POD) 4, she developed acute hepatic encephalopathy (AHE) with acute liver failure, managed with aggressive hepatoprotective therapy. Full neurological recovery was achieved by POD 14, and the patient was subsequently discharged to the ward. Conclusion: This case underscores the importance of meticulous preoperative planning, precise intraoperative haemostasis, targeted postoperative nutritional support, and prompt recognition and treatment of post-hepatectomy liver failure in achieving favourable outcomes in complex hepatic surgery.
