Liver Resection Surgery (For Cancer & Benign Conditions)

Dr Tan Yu-Meng
Director, Consultant General Surgeon

What Is Liver Resection Surgery?

Liver resection surgery, also known as hepatectomy, is a medical procedure aimed at removing a portion of the liver. The liver has unique regenerative capabilities, enabling it to recover even after a significant portion has been surgically removed.

This operation is primarily performed to treat liver diseases, including cancerous tumors and certain benign conditions affecting liver function. It aims to excise diseased tissue while preserving as much healthy liver tissue as possible to maintain the organ’s functionality.

Causes

Liver resection surgery is indicated for various conditions, notably liver cancer and benign liver conditions.

Liver Cancer

The types of liver cancer that might necessitate resection include:

  • Hepatocellular carcinoma (HCC): The most common form of liver cancer, occurring predominantly in individuals with chronic liver diseases, such as cirrhosis.
  • Intrahepatic cholangiocarcinoma: A less common form of liver cancer that begins in the bile ducts within the liver.
  • Liver metastases: Secondary liver cancers that have spread to the liver from other primary sites, such as the colon, breast, or lung.

Benign Liver Conditions

Benign liver conditions that may require liver resection include:

  • Hepatic adenomas: These are benign tumors that can sometimes grow large or rupture, posing a risk of internal bleeding.
  • Focal nodular hyperplasia (FNH): A benign liver lesion that is usually asymptomatic but may require removal if it causes symptoms or its nature is uncertain.
  • Hepatic hemangiomas: These are benign vascular tumors of the liver, but large or symptomatic hemangiomas might necessitate resection.

Types of Liver Resection Surgery

The main types of liver resection include:

Partial hepatectomy involves removing a portion of the liver that is smaller than an entire lobe, and it is often used when the diseased tissue is localised within a confined area of the liver.

The liver is divided into two main lobes: the right and the left lobe and a lobectomy involves removing one of them. Removing the larger right lobe is more common due to the liver’s anatomy and the distribution of diseases within it.

The liver is further divided into eight segments and segmentectomy involves removing one or more of these segments. This approach is highly precise and is used when the disease is confined to specific liver segments, allowing for maximum preservation of healthy liver tissue.

Surgical Techniques

The choice of surgical technique for liver resection depends on various factors, including the location and size of the liver portion to be removed, the patient’s overall health, and the surgeon’s expertise. The main surgical techniques include:

Open Surgery

Involves a large incision for direct access and visibility of the liver, enabling extensive resections as needed.

Laparoscopic Surgery

Utilises multiple small incisions for inserting surgical tools and a camera, offering a minimally invasive option with a video-assisted view of the liver.

Robotic-Assisted Surgery

Employs a robotic system to enhance laparoscopic surgery, providing a high-definition, three-dimensional view and greater precision through controlled instruments.

Postoperative Care and Recovery

Key aspects of postoperative care following liver resection include:

  • Monitoring: Patients are closely monitored for any signs of complications, such as bleeding, infection, or liver failure.
  • Pain Management: Pain relief is provided through medications, which are tailored to the individual’s needs and the extent of the surgery.
  • Activity and Rest: Early mobilisation is encouraged to prevent complications such as deep vein thrombosis (DVT). However, activities are gradually increased based on the patient’s tolerance and recovery pace.
  • Nutritional Support: Proper nutrition is essential for healing and liver regeneration. Dietary adjustments and supplements may be recommended to support liver function and overall health.
  • Wound Care: Instructions on how to care for the surgical site are provided, aiming to prevent infection and promote healing.

Risks and Complications

Liver resection, while beneficial for treating various liver conditions, carries inherent risks and potential complications, as with any major surgery.

  • Bleeding: The liver is a highly vascular organ, and surgery can lead to significant blood loss.
  • Infection: As with any surgical procedure, there is a risk of infection at the surgical site or within the abdomen.
  • Liver failure: Removal of a large portion of the liver can sometimes overwhelm the remaining liver’s capacity, leading to liver failure, especially if the liver was compromised prior to surgery. However, this is extremely rare.
  • Bile leak: The resection process can lead to bile leakage from the liver’s cut surface, which may require additional interventions.
  • Post-hepatectomy liver failure (PHLF): This is a serious condition that can occur when the remaining liver is unable to perform the necessary functions for health.

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Dr Tan Yu-Meng

Director, Consultant General Surgeon

Dr Tan continues to be one of few surgeons in Asia who perform specialized surgery for peritoneal malignancies in Asia.

  • MBBS (Bachelor of Medicine & Surgery, First Class Honors & Distinction at the University of London) 1994
  • RCSEd (Fellow of the Royal College of Surgeons Edinburgh) 1999
  • Further training in advanced HPB surgery and liver transplantation at the world renowned Liver Unit of Queen Elizabeth Hospital in Birmingham, United Kingdom.
  • Further training in living donor liver transplantation in Japan.

With his interest in gastrointestinal and hepatobiliary-pancreatic (GI-HPB) surgery and the treatment of cancer, Dr Tan joined the department of surgical oncology at the National Cancer Centre in 2003 as a consultant.

Dr Tan’s interest in the management of peritoneal surface malignancies was part of his effort in leading a multidisciplinary team from NCC to Washington Cancer Institute to adopt the techniques and protocols of peritonectomy and HIPEC (Sugarbaker procedure) from Dr Paul Sugarbaker in 2009.

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    Liver Resection Surgery (For Cancer & Benign Conditions)

    Frequently Asked
    Questions

    How long does it take to recover from liver resection surgery?

    The recovery time varies depending on the type of surgery and the individual’s health. Typically, hospital stays range from 5 to 10 days, with full recovery taking up to 8 weeks.

    Will my liver grow back after surgery?

    Yes, the liver has a unique ability to regenerate. The remaining portion of the liver can grow back to its original size within several weeks to months, though the shape might be slightly different.

    Can I live normally with part of my liver removed?

    Most people can return to their normal activities and have a good quality of life with a portion of their liver removed. The liver’s regenerative capacity allows it to perform its vital functions effectively after surgery.

    How can I prevent complications after liver resection surgery?

    Follow your surgeon’s postoperative care instructions closely, including taking prescribed medications, attending follow-up appointments, avoiding heavy lifting, and gradually increasing physical activity.