Liver resection — formally known as a hepatectomy — is a major surgical procedure to remove a portion of the liver. It is one of the most technically demanding operations in abdominal surgery, but it is also one of the most rewarding: in appropriately selected patients with liver tumours, it offers the best chance of long-term disease control and in many cases, cure.
Why Is Liver Resection Performed?
The most common reasons for liver resection include:
- Colorectal cancer that has spread to the liver (colorectal liver metastasis)
- Hepatocellular carcinoma — primary liver cancer
- Cholangiocarcinoma — bile duct cancer involving the liver
- Benign liver tumours causing symptoms or growing significantly
How Is the Surgery Performed?
- Anaesthetic: The operation is carried out under general anaesthetic. Patients are carefully assessed beforehand to ensure the remaining liver will be sufficient to maintain function after the resection.
- Access: In most cases, an open approach is used through an incision in the upper abdomen. Laparoscopic (keyhole) liver resection is performed at specialist centres for suitable cases, and is associated with a faster recovery.
- Resection: The diseased segment, lobe, or portion of liver is carefully removed. The extent of resection is determined by the size and location of the tumour, and by the volume and quality of the remaining liver tissue.
- Vascular control: The liver has a dual blood supply, and careful management of the hepatic vessels is central to the safety of the operation.
- Closure: The abdomen is closed in layers. Drains may be left in place to monitor for bile or blood in the early post-operative period.
The Liver's Remarkable Regeneration
One of the features that makes liver resection possible as an operation is the liver's capacity to regenerate. After removal of a portion of liver tissue, the remaining liver grows to compensate — often reaching close to its original volume within six to eight weeks. This regenerative capacity is one of the most extraordinary in human biology, and it is what allows surgeons to remove substantial portions of the liver safely in patients with healthy underlying liver tissue.
Recovery
- Hospital stay: Most patients remain in hospital for 5–7 days after open liver resection. Laparoscopic resection typically allows earlier discharge.
- Return to activity: Full recovery takes approximately 6–8 weeks for major open resections. Patients are encouraged to increase activity gradually.
- Diet: A light, nutritious diet supports liver regeneration. Alcohol should be avoided in the post-operative period.
- Follow-up: Regular imaging and blood tests are arranged to monitor liver function and watch for recurrence of disease.
Risks
As with any major operation, liver resection carries risk. These include bleeding, infection, bile leakage, liver insufficiency, and general surgical and anaesthetic complications. The risk profile depends significantly on the extent of resection, the quality of the remaining liver, and the patient's overall health. These will be discussed in detail during your consultation.