A hepatectomy, or liver resection, is a surgical procedure to remove a portion of the liver.
This operation is typically performed to treat liver cancer, benign liver tumors, or other forms of liver disease.
If you have a part of your liver removed, it can regrow to its original size. If you have a total hepatectomy, you will need a liver transplant to replace your liver.
Learn more about hepatectomy, including its definition, indications, candidate criteria, the surgical process, post-operative care, and potential risks and complications.
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What is a hepatectomy?
A hepatectomy, or liver resection, involves the surgical removal of a portion of the liver.
Depending on the extent of the disease and the patient’s health, the procedure can vary from removing a small wedge of liver tissue to removing an entire lobe.
The liver has a remarkable ability to regenerate, making it possible to remove substantial portions while still maintaining liver function.
Why would someone need a liver resection?
Many people undergo liver resection to treat cancer or other forms of liver disease. Others may have a liver resection so they can donate part of their liver for a living donor liver transplant.
Learn more about liver transplant>>
Liver cancer
- Hepatocellular carcinoma (HCC): The most common type of primary liver cancer.
- Cholangiocarcinoma: Cancer that originates in the bile ducts within the liver.
Metastatic liver cancer
- Colorectal cancer metastasis: Cancer that has spread from the colon or rectum to the liver.
- Other metastatic cancers: Spread of cancers from other organs to the liver.
Learn more about colorectal cancer>>
Benign liver tumors
- Hepatic adenoma: A benign liver tumor that may cause symptoms or has a risk of bleeding.
- Focal nodular hyperplasia (FNH): A benign liver lesion usually detected incidentally.
- Hemangiomas: Large or symptomatic vascular liver tumors.
Other liver conditions
- Liver cysts: Large or symptomatic cysts that cause discomfort or other complications.
- Liver abscess: Infection causing a pus-filled cavity that may require surgical drainage.
Candidate criteria for liver resection
Clinical assessment
- Severity of disease: Candidates typically have localized liver disease that is resectable and has not spread beyond the liver.
- Impact on quality of life: Symptoms affecting the patient’s daily life and overall health.
Health evaluation
- Overall health: Candidates should be in good general health aside from the liver condition. Medical optimization may be necessary to address coexisting conditions.
- Liver function: The remaining liver function must be adequate to sustain life after resection.
Learn more about getting healthy for surgery>>
Preoperative evaluations
- Blood tests: Comprehensive blood work to assess liver function, coagulation profile, and overall health.
- Imaging studies: CT scan, MRI, or ultrasound to evaluate the extent of the disease and the anatomy of the liver.
- Cardiac and pulmonary assessments: Tests to ensure the heart and lungs are functioning well enough to undergo surgery.
Exceptional cancer care
The hepatectomy process
Preoperative preparation
- Consultation: Detailed discussions with a multidisciplinary team, including hepatologists, surgeons, and oncologists, about the procedure, benefits, risks, and alternatives.
- Medical optimization: Managing any underlying conditions and stabilizing the patient’s health before surgery.
- Nutritional support: Addressing any nutritional deficiencies to improve overall health and recovery potential.
Surgical steps
- Anesthesia: General anesthesia is administered to ensure the patient is asleep and pain-free during the procedure.
- Incision: An incision is made in the abdomen to access the liver. The location and size of the incision depend on the portion of the liver being removed.
- Liver resection: The affected portion of the liver is carefully separated from surrounding tissues and blood vessels and then removed.
- Hemostasis: Careful control of bleeding from the liver tissue and blood vessels.
- Closure: The incision is closed using stitches or staples.
Duration
- Timeframe: The procedure typically takes between 3 to 6 hours, depending on the complexity.
Postoperative care and recovery
Immediate postoperative care
- Intensive care unit (ICU): Close monitoring in the ICU for the first several days after surgery to ensure stability and manage pain.
- Pain management: Administration of pain relief medications to ensure comfort during recovery.
- Infection control: Measures to prevent infections, including administering antibiotics and maintaining sterile environments.
Hospital stay
- Duration: The average hospital stay is about 5 to 10 days, depending on recovery progress and any complications.
Rehabilitation and follow-up
- Physical therapy: Rehabilitation exercises to support physical recovery and overall well-being.
- Nutritional support: Specialized dietary plans to ensure adequate nutrition and support liver health.
- Follow-up appointments: Regular check-ups with the surgical team to monitor progress and detect any complications early.
Potential risks and complications
Surgical complications
- Infection: Risk of infection at the surgical site or within the abdomen.
- Bleeding: Risk of bleeding during and after surgery.
- Bile leakage: Leakage of bile from the liver or bile ducts, which may require additional interventions.
- Vascular issues: Complications related to the blood vessels, such as thrombosis or stenosis.
Long-term complications
- Liver dysfunction: Depending on the amount of liver removed and the patient’s liver health, there is a risk of liver failure.
- Recurrence of disease: Risk of cancer recurrence, particularly in cases of liver cancer or metastatic disease.
Impact on quality of life
- Nutritional challenges: Difficulty maintaining a healthy weight and nutritional status due to dietary restrictions and recovery needs.
- Emotional and psychological impact: Stress, anxiety, and depression related to the surgical procedure, recovery, and long-term medical needs, requiring ongoing support and counseling.
A hepatectomy is a complex but potentially curative procedure for patients with certain liver conditions such as liver cancer, benign liver tumors, or other liver diseases.
Early diagnosis, careful candidate selection, meticulous surgical intervention, and comprehensive post-operative care are crucial for improving outcomes and quality of life.
If you are a candidate for a hepatectomy, consulting with a specialized medical team will help develop an individualized care plan tailored to your specific needs and circumstances.
