On January 5, 2022, Associate Professor Sha Huanchen, Director of Department of Hepatobiliary Surgery in East District of the First Affiliated Hospital of Xi 'an Jiaotong University (XJTU), was on his way to the operation room to perform emergency surgery for a patient suffering from a giant liver tumor.
The male patient was aged 59 years. After admission, Director Sha Huanchen delivered physical examination and identified "a palpable giant abdominal tumor, which was visually apparent." The findings of CT scan were even more severe that "the giant liver tumor almost occupied the whole abdominal cavity, which is extremely rare and challenging to resect. Based on clinical experience, the success rate of complete resection is highly low." As the tumor squeezed surrounding organs, the patient not only experienced intolerable pain and sleepless night, but also presented with eating difficult. He experienced unbearable suffering of mind and body caused by this disease.
Director Sha Huanchen immediately submitted an application for Multidisciplinary Diagnosis and Treatment (MDT) consultation to Department of Hepatobiliary Surgery of the main hospital. After MDT expert consultation by Department of Hepatobiliary Surgery, Department of Anesthesiology and Perioperative Medicine, and Department of Imaging of two divisions, it was unanimously confirmed that no extrahepatic metastasis of cancer cells occurred in this patient, and surgical resection was feasible. Although the surgery was extremely challenging, it was the final option to save his life.
Director Sha Huanchen immediately organized an operation team and formulated a detailed surgical plan. The giant liver tumor left hardly no extra space for surgical procedures and significantly increased the difficulty of organ and structural exposure. It was impossible to place the hepatic hilar occluder. The surgery is extremely risky and challenging, simply like disposing a bomb within the patient’s body.
After full preoperative preparations, the surgical team led by Associate Professor Sha Huanchen, Director of Department of Hepatobiliary Surgery, and Attending Physician Xu Kedong, performed the surgical procedures according to preoperative surgical plans on January 5, 2022. Under MDT cooperation including Department of Anesthesiology and Perioperative Medicine and alternative departments, the surgical team successfully resected the giant liver tumor after more than 3 h surgery. Intraoperative blood loss was estimated to be only 200 ml. The resected tumor was 25 cm in diameter and weighed nearly 3 kg. Postoperatively, the patient’s vital signs were stable, and then he was transferred to the ward for subsequent treatment.
