Liver Surgery Hepatectomy – Liver resection – Partial hepatectomy
What is Liver Surgery (Hepatectomy)?
Liver surgery, also known as hepatectomy or liver resection, involves removing a portion of the liver affected by tumours, lesions, or other diseases.
The goal is to eliminate the diseased tissue while preserving as much healthy liver as possible.
Key Facts About Liver Surgery
Liver Conditions That May Require Treatment
The liver can be affected by various conditions, some of which may require surgical intervention.
Common liver problems include:
- Liver Tumours (Benign & Malignant)
- Hepatocellular carcinoma (HCC) – The most common primary liver cancer.
- Metastatic liver cancer – Spread from cancers like colorectal, breast, or lung.
- Benign tumours – Such as hemangiomas or adenomas (may need removal if large or symptomatic).
- Liver Cysts
- Simple cysts (usually harmless) vs. polycystic liver disease (may require drainage or surgery).
- Liver Abscesses
- Bacterial or parasitic infections (e.g., pyogenic abscess, amebic abscess) that may need drainage.
- Bile Duct Disorders
- Gallstones blocking bile flow, cholangiocarcinoma (bile duct cancer), or strictures.
- Cirrhosis & Liver Damage
- Severe scarring from alcohol abuse, hepatitis B/C, or fatty liver disease can lead to liver failure.
When is Liver Surgery Required?
Liver resection is recommended in cases where non-surgical treatments (medication, ablation, or chemotherapy) are insufficient.
Common scenarios include:
- Liver Cancer (Primary or Metastatic)– Removing tumours before they spread.
- Large or Symptomatic Benign Tumours– If they cause pain, bleeding, or risk rupture.
- Traumatic Liver Injury– Severe damage from accidents requiring surgical repair.
- Living Donor Liver Transplant– A portion of a healthy liver is removed for transplant.
- Bile Duct or Gallbladder Cancer– Requires partial liver removal in some cases.
- Liver Infections/Abscesses– If antibiotics or drainage fail.
Your doctor will assess whether surgery is the best option based on liver function, tumour size, and overall health.
Liver Surgery Procedure: What to Expect
Before Surgery
- Comprehensive evaluation (imaging, blood tests) to assess liver function and surgical feasibility.
- Possible portal vein embolization (PVE) to encourage liver growth before major resection.
During Surgery
- Anesthesia: The patient is placed under general anesthesia.
- Incision:
- Open surgery: A single large incision in the abdomen.
- Minimally invasive (laparoscopic/robotic): Small keyhole incisions (8mm-12mm).
- Resection: The surgeon removes the affected liver tissue along with a margin of healthy tissue.
- Reconstruction: Blood vessels and bile ducts may be repaired to ensure proper function.
- Confirmation: Blood flow and liver function are checked in the remaining liver.
After Surgery
- Hospital stay: Several days for monitoring.
- Pain management, IV fluids, and antibiotics as needed.
- Most patients can eat within 48 hours.
Types of Liver Resection
The type of surgery depends on the size, location, and extent of liver disease:
Type of Resection | Description |
Wedge Resection | Removal of a small, wedge-shaped portion of the liver. |
Segmental Resection | Removal of an entire liver segment. |
Lobectomy | Removal of an entire lobe (right or left) of the liver. |
Laparoscopic/Robotic Minimally Invasive Liver Surgery
The traditional approach to liver resection has required an open cut in the upper part of the abdomen. However, in expert hands, many liver resections can be done either laparoscopically or robotically via small (8mm-12mm) incisions.
This allows precise surgery with decreased blood loss, a lower risk of complications and decreased hospital length of stay. Most patients also find that they can return to regular activities sooner.
Laparoscopic or robotic resection may not be suitable in all patients with the appropriate surgical approach decided upon on a bespoke basis in a multidisciplinary setting.
- Benefits: Smaller incisions, less blood loss, faster recovery, shorter hospital stay.
- Suitability: Not all patients qualify—depends on tumour size, location, and liver health.
Risks & Complications of Liver Surgery
Liver resection is major surgery, and potential risks include:
- Bleeding
- Infection
- Bile leakage
- Liver failure (rare but serious)
- Blood clots, pneumonia, or heart complications due to surgical stress
- Need for additional procedures
The risks of surgery and how they apply to each patient are usually discussed during any consultation when surgery is planned and again when consent for surgery is obtained.
Recovery After Liver Surgery
After surgery, the patient is closely monitored in the hospital for several days to ensure proper healing and to watch for any signs of complications. Pain management, intravenous fluids, and antibiotics may be administered as needed. Most patients can eat relatively quickly after surgery (within about 48 hours).
After being discharged from hospital, patients can require a further period of convalescence. Studies indicate that the liver regenerates a significant amount in the first six weeks after surgery.
During this period, patients can experience a sense of fatigue that is hard to describe.
Patients are not confined to bed-rest nor incapacitated but might require more rest than usual (e.g. an afternoon nap) or be able to do less when tasks are physically demanding (e.g. mowing lawns).
Hospital Recovery
- 3–7 days of monitoring.
- Gradual reintroduction of food and mobility.
At-Home Recovery
- Fatigue is common—patients may need extra rest (e.g., afternoon naps).
- Avoid strenuous activities (e.g., heavy lifting, mowing lawns) for 4–6 weeks.
- The liver regenerates significantly within the first 6 weeks.
Follow-Up Care After Liver Surgery
Regular follow-up visits with a healthcare provider are crucial for individuals who have undergone liver resection. These visits are essential to monitor the recovery process, assess liver function, and detect any signs of cancer recurrence (if appropriate) or complications.
Depending on the specific condition, additional treatments such as chemotherapy may be required following surgery.
Regular check-ups are crucial to:
- Monitor liver function
- Detect cancer recurrence (if applicable)
- Manage complications early
- Determine if additional treatments (chemotherapy, radiation) are needed
Liver surgery is a life-saving procedure for patients with tumours or severe liver disease. Advances in minimally invasive techniques have improved recovery times and outcomes.
If you or a loved one needs liver surgery, consult a specialised liver surgeon to discuss the best approach
Frequently Asked Questions (FAQs) About Liver Surgery
What is liver surgery (hepatectomy) used for?
Liver surgery removes part of the liver affected by tumours (cancerous or benign), cysts, infections, or trauma. It’s also done for living donor liver transplants.
How much of the liver can be safely removed?
Up to 70-80% of a healthy liver can be removed because it regenerates. However, patients with cirrhosis or liver disease may tolerate less removal.
Is liver surgery open or minimally invasive (laparoscopic/robotic)?
Both options exist. Open surgery uses a large incision, while laparoscopic/robotic surgery uses small keyhole cuts for faster recovery. The best approach depends on tumour size, location, and liver health.
How long does liver surgery take?
It varies but typically takes 3–6 hours, depending on complexity. Major resections (like lobectomies) may take longer.
Will I need chemotherapy after liver surgery?
If the surgery was for cancer, additional treatments (chemotherapy, radiation, or immunotherapy) may be needed to prevent recurrence.
Can the liver grow back after surgery?
Yes! The liver is the only organ that regenerates. Most regrowth happens in 6 weeks, with full recovery in 3–6 months.
What are the risks of liver surgery?
Possible risks include bleeding, infection, bile leakage, liver failure, blood clots, or pneumonia. Serious complications are rare in experienced centers.
How long is the hospital stay after liver surgery?
Most patients stay 5–7 days after open surgery and 2–4 days after laparoscopic/robotic surgery.
How painful is liver surgery recovery?
Pain is managed with medications.
First week: Moderate pain (controlled by IV/oral meds).
After 2 weeks: Discomfort improves significantly.
How long does it take to recover fully?
• 2–4 weeks: Return to light activities.
• 6–8 weeks: Most patients resume normal activities (work, driving).
• 3–6 months: Full liver regeneration.