(Resection, Hepatic; Liver Resection; Resection, Liver)
Definition
Definition
Hepatic resection is surgery to remove a portion of the liver.
Reasons for Procedure
Reasons for Procedure
Hepatic resection is most often used to treat cancer in the liver. It can also be done for the following reasons:
- Treat other tumors in the liver, including non-cancerous lesions
- Treat cancer that has spread to the liver—most often seen in those with colon cancer
- Liver transplant donation
- Treat trauma to the liver
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Possible Complications
Possible Complications
Your doctor will review possible complications such as:
- Excess bleeding
- Reaction to anesthesia
- Infection
- Nausea and vomiting
- Low blood sugar
- Liver failure
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Long-term side effects are uncommon. This is because the liver is able to regrow and function normally within a few months. But, this can happen more slowly in older people.
What to Expect
What to Expect
Prior to Procedure
Your doctor may do some of the following:
- Physical exam
- Blood tests
- Liver function tests
- You may be given chemotherapy to shrink liver tumors
- You may meet with a doctor who specializes in liver surgery
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Your doctor may do tests to determine the exact location of the tumors:
- Abdominal ultrasound —a test that uses sound waves to make an image in the abdomen
- CT scan —a type of x-ray that uses a computer to make pictures of structures in the abdomen
- PET scan —a test that uses a small amount of radiation to locate areas in the body with abnormal metabolic activity, such as cancers
- MRI scan —a test that uses magnetic waves to make picture of structures in the abdomen
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
Anesthesia
General anesthesia will be used. It will block any pain and keep you asleep through the surgery.
Description of the Procedure
The doctor will make an incision in the right upper abdomen, under the rib cage. The doctor will remove any tumors on the liver and some of the surrounding healthy tissue. Sometimes, the gallbladder will also need to be removed. The doctor may use an ultrasound probe to examine the liver during surgery to make sure there are no remaining tumors. Your doctor may leave a drain going from inside your abdomen to outside your body. This will drain any blood or leakage from the liver. The doctor will close your incision with stitches or staples.
Immediately After Procedure
You will be taken to the intensive care unit for about 24 hours. The hospital staff will monitor you.
How Long Will It Take?
3-7 hours
How Much Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital Stay
The usual length of stay is 3-7 days. The doctor may choose to keep you longer if there are complications.
Post-procedure Care
At the Hospital
- You will receive nutrition through an IV. It will be removed once you are eating and drinking.
- You may have drains from the incision site to help the wound heal properly. Drains are usually removed before you leave the hospital.
- You may have a small catheter put into your bladder to drain urine. It will be removed in a few days.
- You will be given medications to manage pain. These may be given through injections, your IV, or through a pump attached to a needle in your arm.
- You may be given medications to prevent nausea.
Preventing Infection
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as:
- Washing your hands often and reminding your healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incision
At Home
Recovery takes up to 6 weeks. Your doctor may advise pain medications for discomfort. Your activity will be restricted while you recover. Follow instructions on wound care to prevent infection.
Call Your Doctor
Call Your Doctor
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
- Redness, swelling, increasing pain, excessive bleeding, warmth, drainage, or bulging at the incision site
- Yellow skin color
- Itchy skin
- Changes in mental status
- Persistent nausea and/or vomiting
- Severe abdominal pain and/or swelling
- Signs of infection, including fever and chills
- Cough, shortness of breath, or chest pain
- Pain and/or swelling in your feet, calves, or legs
- Feeling weak or lightheaded
If you think you have an emergency, call for medical help right away.
RESOURCES:
American Liver Foundation http://www.liverfoundation.org
CANADIAN RESOURCES:
References:
Hartog A, Mills G. Anaesthesia for hepatic resection surgery. Contin Educ Anaesth Crit Care Pain. 2009;9(1):1-5.
Lai LW. Hepatic resection for colorectal liver metastases. Singapore Med J. 2007;48(7):635.
Treatment for secondary liver cancer. Macmillan Cancer Support website. Available at:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Liversecondary/Treatingsecondarylivercancer/Treatmentoverview.aspx
Updated January 1, 2013. Accessed February 26, 2014.
van den Broek MA, Damink SM, et al. Liver failure after partial hepatic resection: Definition, pathophysiology, risk factors, and treatment. Liver Int. 2008;28(6):767-780.
Zakaria S, Donohue JH, et al. Hepatic resection for colorectal metastases: Value for risk scoring systems? Ann Surg. 2007;246 (2):183-191.
6/6/2011 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: A systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
Last Updated: 2/26/2014