Wockhardt Hospitals has proved its medical one-upmanship yet again by successfully performing a major liver re-resection on a 58 year old man. In a case of a recurrent cancerous liver tumor which many hospitals worldwide would shirk from taking up for a second surgery, the expert team at Wockhardt Hospitals led by Dr S K Mathur took the challenge and skillfully excised the tumors in an arduous 11- hour surgical procedure

1. Liver: An Enigma By Dr. S K Mathur MS, FACS Sr. Consultant GI Surgeon HPB Surgery & Liver Transplantation, Wockhardt hospitals, Mumbai Past President : Indian Chapter of International HPB Association Indian Association

5. Prediction of Hepatic Insufficiency Hepatic Volumetry Normal Liver : Segments Volume 5 + 8 30 % 6 + 7 35 % 1 + 4 20 % 2 + 3 15 % 65 % of Right Liver 35 % of Left Liver (Stone et al Am J Surg 1969)

7. Liver : Uniqueness Capacity for Regeneration In 6 weeks liver regenerates to 90% of its original volume

8. In Greek mythology, Prometheus (Ancient Greek:"forethought")[1] is a Titan known for his wily intelligence, who stole fire from Zeus and gave it to mortals for their use.[2] Zeus then punished him for his crime by having him bound to a rock while an eagle ate his liver every day only to have it grow back to be eaten again the next day.

11. Liver Cancer (Hepatocellular Carcinoma)

15. Digestive cancers at TMH 1994-95 Site 1994 1995 All GI 2277 2347 Esophagus 902 921 Large bowel 617 666 Stomach 359 341 Gall bladder 161 167 Pancreas 1 12 134 Liver 88 88 Others 28 30

20. Hepatocellular Carcinoma Diagnosis : Tumour Markers: - - AFP > 400 ng/ml - DCP (des - y - carboxy prothrombin) - CEA

26. SURGERY- ANTERIOR TRANSHEPATIC RESECTION Weight 2 .5Kg

29. Story of a patient with recurrent liver cancer Agony to Smile

34. IVC Tumors Tumor Liver

35. Advised Palliative Treatment: Underwent two cycles of TACE in April and June 2009 One tumor nodule which was flush with the IVC could not be embolised

41. CT Scan

42. Sectorectomy

43. Right hepatectomy

44. Story of a patient with recurrent liver cancer Video

51. THANK YOU