Treated by : Dr. Swapnil Kapote

Patient's Name : Mr. Baba Husain Shaikh

A 60-year-old male patient presented with chief complaints of pain and fullness in the stomach with black-colored stool. No H/O medical co-morbidities. Upon investigation he was found to have hepatocellular carcinoma of left lobe with involvement of lesser curvature of stomach. Relevant investigations are as follows:-

CT abdomen- Lobulated mass of 10 x 15 x 12 cm in the left lobe of liver involving entire segment II & III with lesser curvature of the stomach.

• Biopsy- Hepatocellular carcinoma
• AFP- 3100 IU/ML
• CEA- 1.3
• SGOT- 78
• SGPT- 49

Anesthesia evaluation is done and the patient was posted for left hepatectomy by Gastro Surgeon Dr. Hunaid Hatimi and Onco Surgeon Dr. Swapnil Kapote. Patient induced with weight-adjusted doses of propofol and scoline and maintained on isoflurane, atracurium, and oxygen nitrous oxide for general endotracheal anesthesia. Hemodynamic monitoring is done using the arterial line. Intr-operative blood loss was approximately 4.5 liters which were replaced with 4 liters of crystalloids, 3 point PCV, and 2 point FFP. Surgical duration 5 hrs. Hemodynamic stability was achieved with time and opt use of inotropes and maintaining satisfaction urine output.

Postoperatively the patient was shifted to ICU for elective ventilation overnight. 2 point PCV and 2 points FFP were transfused postoperatively and the patient was extubated on the 2nd day after adequate tapering of inotropes. Orals were started on the 3rd postoperative day and the patient was shifted out of ICU after adequate mobilization. Recovery was assisted with IV amino acids, albumin, and with high protein diet later on. The patient’s recovery was well managed and then he was discharged on the 10th day.