The liver is our body's unsung hero, performing over 500 vital functions to keep us healthy. When a problem arises within the liver, such as a tumor or growth, a surgical procedure called a liver resection may be recommended. This blog post aims to empower patients facing liver resection by providing a comprehensive overview of the procedure, from its purpose and types to recovery and risks.

What is a Liver Resection?

A liver resection, also known as a hepatectomy, is a surgical procedure to remove part or all of the liver. The liver is remarkably resilient, and even after a significant portion is removed, the remaining healthy tissue can regenerate and grow back to its original size.  This surgery is typically performed to treat:

Liver cancer: The most common reason for a liver resection is to remove cancerous tumors originating in the liver, such as hepatocellular carcinoma (HCC) or bile duct cancer.
Benign liver tumors: While less frequent, some benign tumors can grow large enough to cause pain or other problems, necessitating removal.
Liver metastases: Cancer that has spread (metastasized) from other organs to the liver can sometimes be treated with liver resection, particularly for cancers like colorectal cancer or neuroendocrine tumors.

When is Liver Resection Recommended?

The decision to undergo a liver resection depends on several factors, including:

The type and size of the liver mass: Generally, the success of the surgery relies on removing all cancerous tissue with a margin of healthy liver tissue surrounding it. The size and location of the mass will determine the feasibility of complete removal.
Liver function: Liver health is crucial. Tests will assess your liver's ability to regenerate and function properly after surgery.
Overall health: Pre-existing medical conditions are considered to ensure you can tolerate the surgery and recovery.

Types of Liver Resection

The type of liver resection performed depends on the size and location of the liver mass to be removed. Here's a breakdown of some common approaches:

Wedge Resection (Segmentectomy): This involves the removal of a small, wedge-shaped portion of the liver containing the tumor or lesion. It's often used when the affected area is small and located on the periphery of the liver.

Segmental Resection (Segmentectomy): In this procedure, a larger portion of the liver, known as a liver segment, is removed. The liver is divided into eight segments, and segmental resection involves the removal of one or more of these segments.

Hemihepatectomy: This involves the removal of one half (left or right) of the liver. It's typically performed when the tumor or lesion is located in one lobe of the liver or when there's a need to remove a large portion of the liver.

Extended Hepatectomy: In cases where the tumor or lesions are widespread or when there's a need to remove a significant portion of the liver, an extended hepatectomy may be performed. This involves the removal of more than half of the liver.

Non-Anatomical Resection: Instead of following the natural divisions of liver segments, non-anatomical resection involves removing a portion of the liver that doesn't conform to these segments. It may be used when the tumor or lesion is located in a difficult-to-access area.

Radiofrequency Ablation (RFA) or Microwave Ablation (MWA): While not technically liver resection, these minimally invasive procedures involve using heat (RFA) or microwave energy (MWA) to destroy tumors or lesions in the liver. They are often used for small tumors or for patients who are not candidates for surgery.

What to Expect During Liver Resection Surgery

Liver resection is typically performed under general anesthesia. The surgical approach will depend on the type of resection needed. Here's a general outline:

Open surgery: A traditional open incision is made in the upper abdomen to access the liver.
Laparoscopic surgery: Several small incisions are made, and thin instruments and a camera are inserted to visualize and perform the resection.
Bleeding control: Blood vessels are meticulously tied off to prevent bleeding.
Closure: The remaining liver tissue is brought together, and the incision is closed with sutures or staples.

Recovery after Liver Resection

Following surgery, you'll be monitored in a recovery room before being transferred to a hospital room. The recovery process typically involves:

Pain management: Pain medication will be administered to manage post-surgical discomfort.
Drains: Temporary tubes may be placed to drain fluids from the surgical site.
Diet: You'll gradually progress from a clear liquid diet to a regular diet as tolerated.
Physical therapy: Exercises will help with breathing, prevent blood clots, and promote healing.
Length of stay: The duration of hospitalization can vary depending on the complexity of the surgery and your recovery progress.

Potential Risks and Complications

As with any surgery, liver resection carries some risks and potential complications, including:

Bleeding: This is a potential risk during and after surgery.
Infection: There's a risk of infection at the surgical site.
Leakage of bile: Bile is a fluid produced by the liver, and leakage can occur in some cases.
Liver failure: If a significant portion of the liver is removed and the remaining tissue doesn't function adequately, liver failure can occur.
Recurrent cancer: There's a possibility that cancer may recur after surgery, depending on the type and stage of the cancer.

Liver resection is a complex but potentially life-saving procedure for patients with liver tumors.  This blog post has provided a general overview;  remember, it's important to discuss the specifics of your situation with your doctor.  They can address your individual needs and concerns and guide you through the entire process, from diagnosis to recovery.