Liver Resection

Liver Resection, also referred to as a hepatectomy is the surgical removal of all or a portion of the liver.

November 18, 2021

Liver Resection, also referred to as a hepatectomy is  the surgical removal of all or a portion of the liver.

Some facts about Liver Resection:

  • Liver Resection can be done for people who have a single tumour or a limited number of tumours and people who do not have cirrhosis, or only have early stage cirrhosis.
  • The part of the liver where the cancer exist will be removed by the surgeon.
  • The amount of liver that has to be removed depends on the size and position of the tumour or tumours. It could be either only a small part of the liver or a whole lobe of the liver.
  • It is called a hemi-hepatectomy when a whole lobe of the liver is removed.
  • the liver needs to be working well for a liver resection so that the remaining liver can cope after the operation.
  • Usually there is no such long term side effects after a liver resection as the remaining liver can grow bigger and work as it was doing before.
  • A resection can be done using laparoscopic surgery in some cases. So, a liver resection can be performed either through an open procedure or using minimally invasive procedure.
  • Ablation treatment uses heat to destroy cancer cells during surgery.
  • Both benign or malignant Hepatic neoplasms can be treated by performing hepatectomies.
  • Hepatocellular adenoma, hepatic hemangioma and focal nodular hyperplasia is included for benign neoplasms.
  • Metastases are the most common malignant neoplasms (cancers) of the liver which arises from colorectal cancer that can be controlled by surgical resection.
  • Hepatocellular carcinoma is the  most common primary malignant tumour of the liver which can be treated by surgical resection of liver.
  • Intrahepatic gallstones or parasitic cysts of the liver can also be treated by hepatectomy.
  • Liver surgery is safe when performed by experienced surgeons by using appropriate technology.
  • One cannot live without liver as it is a vital organ of human body which is located in the right upper quadrant of the abdominal cavity.
  • Metabolism of drugs and toxins, removing degradation products of normal body metabolism such as clearance of ammonia and bilirubin from the blood, and synthesis of many important proteins and enzymes such as factors necessary for blood to clot are some of the critical functions of liver.
  • The hepatic artery and the portal vein also known as hepatocytes, and bile ducts are the two channels through which blood enters the liver.
  • Blood leaves the liver through the hepatic veins and drain into the inferior vena cava that immediately enters the heart.
  • Bile is a liquid that is produced by liver which helps dissolve fat and eliminate metabolic waste and toxins through the intestine.
  • Bile is produced by each hepatocyte and is excreted into microscopic channels that join to form bile ducts.
  • A single 'hepatic duct' can be created by joining the bile ducts that brings bile into the intestine.

Preparation for Liver Resection:

  • Try to give up smoking before your operation if you smoke which will help reduce your risk of problems, such as a chest infection and help your wound heal after the operation.
  • Several tests including tests on your heart and lungs will be conducted to make sure you are well enough to cope with the operation.
  • Special compression stockings (TED stockings) will be given to wear during and after the operation to help prevent blood clots forming in your legs.

Procedure for Liver Resection:

  • Laparoscopic liver resection is a minimally invasive procedure that is performed under general anesthesia.
  • Very small incisions are made during the procedure of laparoscopic liver resection and the tumors can be removed from the surface of the liver by using a small fiber optic camera.
  • An open procedure is necessary for larger tumors or tumors located deeper within the liver.
  • Minimal blood loss during the surgery, less pain and discomfort after the procedure, less scarring, both internally and externally, and a shorter hospital stay and recovery time are the benefits of laparoscopic liver resection.
  • Post-operative bleeding and the risks associated with general anesthesia such as heart attack, stroke, and death are the risks associated with laparoscopic liver resection.
  • The open liver resection procedure can be done for larger tumors, or tumors that are located deep within the liver that gives the surgeon operating on the liver good visibility.
  • Improved life expectancy and quality of life following the resection surgery are the benefits of open liver resection.
  • The surgeons will be able to remove less of the healthy, normal liver while still completely remove all of the tumor or tumors.
  • Post-operative bleeding and the risks associated with general anesthesia such as heart attack, stroke, and death are the risks associated with open liver resection.

Recovery of Liver Resection:

  • Enhanced recovery programs is conducted by some hospitals that aim to reduce the time you spend in hospital and help you to recover as quickly as possible.
  • You may be given a diet plan to follow and exercises to do before surgery and supplement drinks to take in these programs. It is called prehabilitation to make sure you are as healthy as possible.
  • The nurses will get you out of bed and encourage you to start drinking and eating as soon as possible after surgery which can help improve your recovery time.
  • You will be in intensive care for about 24 hours after a liver resection.
  • Your blood pressure will be checked regularly by the doctors and nurses to avoid the risk of bleeding after surgery.
  • It is important for you to move your legs regularly and do deep breathing exercises while you are in bed to help prevent chest infections and blood clots.
  • You are usually given painkillers though a pump for the first few days to prevent and control pain after surgery.
  • A constant dose of the painkillers can be given either through a thin tube in your back (epidural), into a vein or into the tissue close to your wound.
  • You can press the button known as patient-controlled analgesia (PCA) to give yourself an extra dose of painkillers if needed. However, it is set in such a manner that you cannot have too much painkiller.
  • You can take the painkiller as tablets when you no longer need painkillers through a pump.
  • You may have a dressing over your wound for the first few days after surgery.
  • Usually the stitches will dissolve on its own. However, it can be taken out after 10 days if you need to have any stitches or staples removed.
  • Inform your doctor if your wound becomes hot, painful or starts to leak fluid as these are some possible signs of infection.