Liver Resection

Who is a candidate for a liver resection

A liver resection is typically considered if you have a single tumor in the liver and it has not spread to the blood vessels. The most common reason for a liver resection is patients who have a single liver cancer tumor that has metastasized from colorectal cancer.

Your doctor will evaluate your case to determine if you are a candidate for a liver resection. When reviewing your case, the following considerations will be evaluated:

• Stage of cancer – if the tumor is very large or there are multiple tumors, surgical removal is complicated
• Location of cancerous tumors – if the liver tumor is close to a blood vessel, you may need a different treatment such as intra-arterial chemotherapy or chemoembolization
• How much surgery will be needed to remove the entire tumor – only a portion of the liver can be removed to preserve function
• How well the organ is functioning – patients with impaired liver function may not be able to handle a liver resection
• Patients overall health – patients who are not in good health may need a different treatment option   

Risks of a liver resection

A liver resection is a complicated operation that should be performed by surgeons with extensive experience. Complications associated with the procedure include:

• Bleeding after surgery
• Blood clots
• Damage to the liver
• Infections
• Pneumonia
• Development of new cancer

What to expect during a liver resection

Most liver resections are performed via a laparotomy. If you have a complicated case or your tumor is hard to access, this is the preferred method. Some patients may be candidates for a laparoscopic liver resection.

A traditional open liver resection is performed under general anesthesia. Your doctor will make an incision in the abdomen to access the liver. Once the liver can be seen, the surgical team will seal off blood vessels and bile ducts feeding the area to be resected. Once the vessels are sealed, your surgeon will remove the diseased tumor and healthy tissue around it. You will be stitched back together once the procedure is complete.

During a laparoscopic liver resection, a camera is inserted into a small incision in the lower abdomen. Your surgeon will cut three other small incisions to fit the surgical tools through. Once the surgeon is in position, he or she will seal off blood vessels and bile ducts that feed the portion of liver that will be removed. Once this is complete, your surgeon will remove the diseased portion of the liver as well as healthy tissue around the tumor. To remove the tumor, your surgeon will cut an incision in the lower abdomen.

Recovery from a liver resection

Recovery from a liver resection is a lengthy process. Directly after surgery, you will be moved to a Post Anesthesia Care Unit (PACU). If you are in severe pain, you may need a patient-controlled analgesia (PCA) device to help you self-manage your pain. Depending on the complexity of your case, you may need to stay in the PACU overnight. You will be taken to a hospital room after your stay in the PACU. You will not be able to eat for a few days after the surgery. You may need to stay in the hospital for a week or more depending on how well you are recovering.

Before being discharged, your doctor will give you detailed discharge instructions including:

• Follow-up appointment schedule – you typically will have an appointment within one to three weeks after discharge.
• Pain management options – either prescription or OTC pain medication may be advised
• Nutrition – eating a balanced diet that is high in protein can help you recover more quickly
• When you can resume your activity level after surgery – gradually return to your activity level and normal routine
• When you can drive – typically you can drive three weeks after surgery