• Liver resection involves removing a part of the liver – usually to treat a tumour or tumours.
• Liver resection relies on the fact that the liver is comprised of eight segments each with a separate blood supply and biliary drainage. Each segment or combination of segments can be removed safely up to 80% of normal liver volume (five to 6 segments in total). Ideally at least 20% of the liver volume should be left after surgery.
• If it looks like this figure may not be achieved after liver resection there are a number of interventions that can be undertaken to increase the size of the remaining liver.

The amount of liver that can be safely removed depends on how healthy the liver is.

• Liver resections are undertaken in three parts – dividing the blood supply to and biliary drainage as well as dividing the venous drainage from the liver to be removed. The final part involves dividing the liver tissue with an ultrasonic dissector (click here) which carefully divides the liver tissue and seals small blood vessels and bile ducts with heat.
• Liver resection can be undertaken via keyhole surgery (click here to see segments 2 and 3 removed using keyhole surgery) or using an open incision (click here to see the right side of the liver removed – segment 5-8)). In addition, at Harbour Surgery we also undertake keyhole surgery liver resections using the Da Vinci surgical robot to enhance the view and accuracy of the surgery.

The ability to perform the procedure laparoscopically or robotically depends on which part of the liver needs to be removed, the size of the tumour, the presence of adhesions from previous surgery and several other factors. The best approach for you will be discussed with you at your consultation.

• Once your surgery has been completed you will be looked after in a high dependency unit where a nurse cares directly for you on the first night post-surgery.
• Daily blood tests will be taken to check that the liver is growing.
• Generally you are able to drink fluids on the night of surgery and progress to a light diet at 24 hours following the operation. The day after surgery the nurses will help you to start moving and walking.
• The average day stay following liver resection is 5 days.
• At Harbour Surgery we usually use dissolving sutures placed under the skin. These do not need to be removed. Usually any incisions are covered with water proof dressing and can remain in place until your first post-operative specialist visit.
• Following discharge you will need to take regular pain relief to maintain mobility and maintain a good oral intake – many patients find that they eat 6-8 small meals per day rather than three large meals over the first few weeks post operation.
• Most patients experience decreased energy for up to 6 weeks following liver resection.
• You will be reviewed by your surgeon approximately 14 days post discharge. Usually a follow up scan of the liver is undertaken 6-8 weeks following surgery.

Complications of liver surgery include:

• Bleeding
• Leak of bile from the cut liver surface
• Ascites (fluid development in the abdomen), jaundice, confusion and liver failure (where the remaining liver is not adequate)
• Overall the risk of dying during liver surgery is very low (<1/100,000). The risk of complications is dependent on the amount of liver removed and the type of operation. The most common complications are requiring a blood transfusion (risk 5%), a small bile leak from the cut edge of the liver (risk 7%: this is usually treated with aspiration under ultrasound guidance), chest infection (risk 5%; this is treated with antibiotics and physiotherapy) and blood clots (risk 1%; this is treated with blood thinning medication for several weeks).