Surgery 2026

The liver is a unique organ with regenerative properties. As such, patients are able to undergo partial hepatectomy for treatment of cancerous lesions with good success. Although complete resection is possible for numerous cancers, palliative hepatectomies for noncurative disease have increased in recent years. Despite the increased frequency there remains no definitive surgical or anaesthetic guidelines on managing such patients with significant variation between institutions and cohorts . Anaesthetic management of such patients can be challenging depending on severity of liver disease and patient associated comorbidities. Several scoring systems and preoperative assessment models such as MELD and Child-Pugh have been developed to risk stratify patients with liver disease . General anaesthetic considerations for patients undergoing hepatectomy are acute blood loss, electrolyte abnormalities, inadequate analgesia, pulmonary and cardiovascular monitoring, and coagulopathies . In our case report we review current anaesthetic recommendations for hepatectomy and present a 46-year-old male with primary neuroendocrine tumour from the rectum with metastasis to the liver, who underwent palliative partial hepatectomy for near complete filling mass of the abdomen.

Smith completed his DO from Touro University Nevada and surgical internship at Grand Strand Medical Center in Myrtle Beach South Carolina. He is currently the Chief anesthesia resident at Vassar Brothers Medical Center in Poughkeepsie, New York. He will be completing a fellowship in Acute Pain and Regional Anesthesia at the University of Utah starting in August.