Major Liver Resection in a Septuagenarian With Multiple Co-Morbid Illnesses
in Max Super Speciality Hospital, Patparganj
Jan 16 , 2023
A 79-year-old male with diabetes, asthma & Parkinsonism, was diagnosed with a large hepatic mucinous cystic neoplasm (HMCN) involving the left lobe of the liver with cholelithiasis and choledocholithiasis on evaluation for abdominal pain and jaundice. He was evaluated by a multidisciplinary team, and his condition was optimised.
Left hepatectomy with Cholecystectomy, CBD clearance and antegrade biliary stenting was done by the GI and HPB Surgical Oncology team at Max Hospital, Patparganj in April 2022.
Despite the resumption of anti-parkinsonian drugs, he developed delirium and psychosis on day 3, which was managed medically. The hospital course going forward was uneventful and he was discharged. The final biopsy report was benign biliary cystadenoma.
He is doing well at the 6-month follow-up with no evidence of recurrence.
HMCNs (earlier termed biliary cystadenoma) are quite often confused with hydatid cysts on imaging, both being multiloculated with septae. A complete resection should be done for suspected HMCNs because of the significant risk of invasive malignancy. With combined efforts of the surgical, anaesthesia, critical care, neurology and pulmonary medicine teams, a successful outcome could be achieved in the patient despite his age and co-morbid illnesses.
Treated by:
