A hepatectomy, also known as a liver resection, is a surgical procedure that involves the partial or complete removal of the liver. The liver has the ability to regenerate, growing back to its original size if the remaining portion is healthy. If the patient’s liver is healthy, they can remove up to two-thirds of it. A liver transplant will be necessary if they have a total hepatectomy.
A liver resection may be performed to address liver disease or for those opting to give a portion of their liver for living donor liver transplantation.
Hepatectomy is regarded as a technically challenging procedure. The liver contains numerous vessels and is prone to substantial bleeding, requiring specialized training for liver surgeons to avoid vessel injury and effectively handle any bleeding. If the resection involves less than half of your liver, the procedure carries lower risks and can be performed using minimally-invasive surgical techniques like laparoscopy or robotic surgery. It becomes riskier and more challenging when the patient requires a major resection (the removal of more than half of their liver). Because of the complexity of the procedure, patients typically prefer to have their liver resection performed by qualified professionals.
Major and minor liver resections are two distinct types for liver resections. A large resection is defined as the removal of more than three segments, whereas a minor resection is the removal of smaller pieces.
Common surgical procedures are as follows:
Partial liver resection is the common procedure used by surgeons to remove a cancerous, precancerous, or benign (noncancerous) tumor.
There are two types of liver cancer: primary, which originates in the liver, and secondary, which originates in another organ and spreads.
Partial hepatectomy is used to treat the following liver tumors that occur most frequently:
Among the other benign lesions are the following:
Complications may include:
A 2% mortality rate is attributed to complications following liver resection surgery. Individuals with cancer assess these risks in relation to the risks of cancer.
Hepatectomy procedures can be carried out using robotic, laparoscopic, or open surgery. The best course of action to treat their disease will be decided by the surgeon.
Because laparoscopic and robotic procedures involve four to six tiny incisions, each measuring around half an inch, they are less invasive than other surgical methods. A quicker and simpler recovery is possible with these tiny incisions. However, more complex or extensive liver resections could require traditional open surgery to handle.
The healthcare provider must weigh a number of factors while determining the best course of action to treat the disease. First, they will assess the patient’s general health to see if they are healthy enough to undergo surgery. Additionally, the decision may depend on whether the lesion in your liver is technically operable and whether you have cancer in other parts of your body, aside from your liver.
Occasionally, to reduce the size of the cancer, make the surgery safer and simpler, or increase the likelihood that the cancer will be cured, radiation treatment, chemotherapy, or interventional radiology are performed prior to surgery.
The decision on whether to do a liver transplant or a partial hepatectomy will also fall to the healthcare provider. This could depend on:
The healthcare provider might recommend to do certain tests on the patient to check for certain factors, such as:
There are differences in the process based on the surgeon’s approach and the amount of liver removed. The hepatectomy procedure may proceed with the following steps:
Depending on how much of the resection, the surgery might take two to six hours.
Most patients will first recover in a post-anesthesia facility before being admitted to an in-patient room. Patients undergoing difficult surgical procedures might have to spend one or two days in critical care after the procedure. They will be equipped with a number of tubes that drain fluids, decompress their stomachs, and provide nutrition. The medical team will keep a careful eye on the patient’s blood glucose levels, fluid/electrolyte balance, and blood loss while they are in critical care. If any abnormalities arise, they will be treated.
The patient will continue to recover in the hospital for up to a week after their condition has stabilized. Gradually, they will start moving about more, restart eating solid food, and have the tubes taken out by the healthcare provider. While they recover, they will take painkillers. Following their discharge, they will schedule a follow-up meeting with their surgeon for two weeks to review the results of their final pathology report and talk about their progress.
Among all cancer treatments, surgery has the highest rate of success. Surgery may be curative if it completely eliminates the cancer. Whether patients have an open, robotic, or laparoscopic treatment, the survival percentage remains the same.
Recovery from a liver resection at home takes four to eight weeks. The patient might have to take a leave from work during this period. During their recovery, individuals shouldn’t attempt to move anything heavy or partake in physically demanding activities. They can take up to 12 weeks to resume all of their regular activities.
Following robotic or laparoscopic surgery, recovery is typically faster. It will take six to eight weeks for them to be able to resume their regular activities after recovering at home for two to four weeks.
A healthy diet rich in protein and daily light activity, such as walking, assists in speeding the healing process. Every day, try to walk for at least thirty minutes, taking breaks as necessary.
Speak with the healthcare provider about any typical post-hepatectomy symptoms, such as:
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