Introduction and Indications
Liver Cancer Resection is the most common surgical procedure performed on the liver to involve part, half or most of the liver. Single or multiple tumours involving the different lobes of the liver can be resected with a high success rate. Liver resection may also be done for benign tumours of the liver, such as cysts, adenomas, and haemangiomas.
For small and superficially located benign tumours, a laparoscopic approach can be performed with success but larger liver masses with close relation to major vessels might require an open operation.
Liver resections require blood transfusion in less than 10% of patients and the procedure may take several hours to complete, depending on the complexity of the resection. Up to 70% of the liver can be safely resected, depending on the pre-existing condition of the liver.
Postoperative ICU admission is a common practice to optimise liver function and to carefully monitor the haemodynamic and coagulation status.
Contra-indications
- Some forms of hepatitis especially the fulminant one.
- Liver failure.
- Inadequate remnant of the liver secondary to previous liver resection.
- General contra-indications including severe heart failure, renal failure and lung failure.
Preoperative Instructions
- Optimise protein intake and exercise.
- Treat jaundice and bile duct obstruction.
- Reduce weight in obese patients.
- Treat infection and optimise renal and heart function.
Postoperative Instructions
- Leave the dressing unchanged over the surgical wound until advised by your surgeon.
- Adequate analgesia.
- Walking and being physical helps to keep the lungs healthy and prevent blood clots from forming.
- Avoid consumption of alcohol.
- Do not eat or drink anything for the first 24 hours after surgery.
- No heavy weight lifting for 6 to 8 weeks.
Risks and Complications
- Surgical Infection.
- Bile leak.
- Bile duct obstruction.
- Blood clots.
- Injury to the main bile duct or other abdominal organs.
- Bleeding.
- Liver failure especially in cirrhotic or small for size liver remnant.
- Failure to remove the tumour completely which affect the prognosis and may require a second operation.
- Mortality depends on the magnitude and complexity of the resection and the pre-existing condition of the liver.
