Liver Resection - National Liver Foundation of Bangladesh

What Is Liver Resection?

Liver resection is a surgical procedure in which part of the liver is removed.

Liver resection may be performed for several conditions, including:

Malignant Tumor:

Primary Liver Cancer:

Metastatic Tumors/Cancer:

These are cancers that begin in another organ and spread to the liver. Examples include cancer that has spread from:

Benign Tumors:

These are noncancerous tumors, including:

Depending on the location and extent of the disease, different types of liver resection may be performed:

Right hepatectomy: removal of the right side of the liver
Left hepatectomy: removal of the left side of the liver
Bisegmentectomy: removal of two liver segments
Trisegmentectomy: removal of three liver segments
Donor hepatectomy: liver resection during a liver transplant where the donor's liver or part of liver is resected.

In general, approximately 25% to 65% of the liver may be removed, depending on the individual case.
The decision depends mainly on the amount and function of the liver (future liver remnant, FLR) that will remain after surgery.
In a healthy liver, approximately 20% to 30% of functional liver tissue should generally remain.
If the patient has cirrhosis, cholestasis, fatty liver (steatosis), or has previously received chemotherapy, greater caution is required. In such cases, approximately 30% to 40% or more of functional liver tissue may need to remain, depending on the patient's condition.
Preventing impaired liver function and liver failure (PHLF) after surgery is an important part of surgical planning.

The liver has a remarkable ability to regenerate and adapt after part of it is removed.

After surgery, the remaining liver increases in size and function. Liver function may recover substantially within approximately 2 to 4 weeks.
The removed portion of the liver potentially regenerates and fills in within about one year.
The degree of recovery depends greatly on the underlying liver disease, the amount of liver removed, and the amount and function of the liver that remains.

Like any major surgery, liver resection can have complications, including:

The outcome of liver resection depends on several factors:

The surgery must be carefully planned.
The patient's liver condition and other medical conditions (comorbid conditions) should be evaluated and controlled before surgery.
The underlying cause of liver disease and the condition of the remaining liver are important factors.
Appropriate surgical equipment and support from other medical departments are essential (the hospital should be an equipped center for liver surgery).
Outcomes are generally better when surgery is performed by an experienced hepatobiliary and pancreatic (HPB) surgeon at a specialized center that regularly performs liver resections.

Benign tumors may be completely cured when they can be safely removed.
Complete recovery may also be possible after certain liver injuries and other localized liver conditions.
For liver cancer, an approximate 5-year survival rate of 30% to 40% is typically expected.
In the case of metastatic tumors, outcomes are better than with the primary tumor. It depends largely on the treatment of the primary tumor.

Properly planned and appropriately performed liver resection can completely treat or control many liver conditions.
Before liver resection, it is essential to carefully assess both the condition of the liver and the patient's overall health.