Hepatectomy (Liver-Removal)

A hepatectomy is a surgical procedure where the liver or a portion of the liver is removed. It is mostly used to treat liver cancer and to prevent cancers that have spread to the liver from spreading even further. It can also help with benign diseases such as cysts and ruptures caused by trauma.

The doctor will decide how the surgery will be done based on the size and location of the tumor. A partial hepatectomy can be done if the size and location of the tumor are in such a way that it can be removed separately. However, if the tumor has spread all over the liver, it must all be removed.

We will briefly describe the structure of the liver before we explain the procedure. The liver is divided into two parts – the right and the left lobes. This division is based on the arteries that supply blood to these lobes. The liver has an exceptional capacity to regenerate, meaning that if a portion is removed, the liver will be able to regenerate it after a while. This, along with advanced methods of surgery and proper postoperative care can significantly aid the recovery process.

The liver has one main job and that is to filter the blood. It filters all the food, drugs, and supplements that you consume every day.

Paraclinical testing for hepatectomy

Your doctor will order medical tests based on your current condition and medical history. These may include: blood tests, ultrasound, CT scan, MRI, and FibroScan.

Preoperative care, the procedure, and postoperative care

Before the procedure

Your doctor might give you a special diet before the surgery. Start fasting from the night before the procedure.

On the day of the surgery you will wear your hospital gown and you will be taken to the operating room. The surgical staff will attach devices that can monitor your blood pressure, heart rate, and oxygen levels throughout the surgery. You will be put under general anesthesia, meaning that you will be unconscious and won’t feel anything.

The hepatectomy procedure

A hepatectomy can be done either as an open surgery or a laparoscopy. During a laparoscopy, the surgeon makes 4 small incisions in your abdomen. Then, he/she will insert the probe (a thin tube with a camera attached to it) along with the tools required for the surgery through these incisions.

Occasionally, surgeons choose to perform an open surgery instead. In this case, one long incision will be made rather than four small ones. The surgeon will close the incision(s) when the procedure is over.

After the procedure

You will be moved to the recovery room once you wake up. Afterwards, you will be taken to the ICU where you will be under supervision for 1-2 days. Then, depending on your condition, you may have to stay in the ward for 4-6 days. Patients that had a laparoscopy will have a shorter recovery period.

Important notes regarding hepatectomy

A long stay at the hospital may be boring for you but it is necessary. During this time your blood sugar, electrolytes, and clotting factors will be monitored.

Notify your doctor if you experience the following symptoms:

• Fever
• Pain and redness in the surgical wound
• Bleeding and problems with clotting
• High or low blood sugar
• Breathing problems

Duration of hospitalization

After a hepatectomy, you will stay at the hospital for 4-6 days. If you will be receiving a liver transplant, you may have to stay for a few weeks.