Liver resection

This page was reviewed under our medical and editorial policy by

Chukwuemeka Obiora, MD, Surgical Oncologist

This page was reviewed on April 7, 2023.

If cancer has been found in your liver, your doctor may suggest removing the part of the organ where the disease is growing. This procedure, called a liver resection or partial hepatectomy, often extends life for patients with liver cancer.

Unlike most of your other organs, the liver can regenerate after surgery, even if up to 70 percent is removed. However, the remaining portion must be healthy. Regrowth can take a few weeks to complete.

Many people with liver cancer have cirrhosis, which is a growing problem in the United States. This scarring of the liver is often caused by too much alcohol consumption or a long-term infection with hepatitis B or C viruses. Too much accumulated fat in the liver also may cause cirrhosis. Cancer patients with cirrhosis may undergo a liver resection if their livers aren’t too damaged and the cancer hasn’t spread.

What does the liver do?

The liver’s life-sustaining functions include:

  • Metabolizing and storing nutrients from food
  • Controlling levels of fat, carbohydrates and protein
  • Making bile to assist the digestion of fats
  • Processing alcohol and medicines and filtering out toxins
  • Defending against harmful bacteria and antigens
  • Creating clotting factors that prevent excessive bleeding
  • Eliminating old cells and waste products from blood

Types of liver resection

From the outside, the liver appears to be divided into two parts, the right and left lobes, which are separated by the umbilical fissure. Another perspective organizes this organ into eight segments determined by their connections to the hepatic artery, portal vein and bile drainage.

Types of liver resection surgery take their names from the portions being removed. For example, a left lobectomy describes the removal of the left lobe, but a left hepatectomy excises segments II, III and IV, which include all of the left lobe and an adjacent part of the right lobe. A segmentectomy refers to removal of one or more segments. Removal of the right side of your liver may include your gallbladder.

  • Anatomical resection means removal of the tumor and the veins draining that area of the liver. Often it involves two or more segments of the liver. It’s thought that malignant cells from the tumor spread along these blood vessels, so removing the veins may remove microscopic bits of cancer that could become tumors.
  • Non-anatomic resection, also called a wedge resection, means removal of the tumor and a surrounding margin of tissue. It may spare more of the working or functional liver tissue, called the parenchyma.
  • Laparoscopic surgery, in which instruments are inserted into the abdomen through small incisions, can result in less blood loss, reduced need for pain medication and shorter hospital stays, as opposed to traditional open surgery.

Benefits, risks and complications of liver resection

A liver resection is one of the most successful ways to treat this type of cancer or extend life, aside from a liver transplant. However, there are possible risks and complications to consider, too.

Bleeding: Your body’s blood passes through the liver, so it’s no surprise that bleeding is a major concern for liver surgery. Since this organ also contributes to blood clotting, an unhealthy liver and any damage caused by surgery may cause problems. Your surgeon can use methods to limit the risk of bleeding.

Cancer recurrence: Studies indicate that a liver resection in patients with metastatic tumors may promote tumor recurrence, perhaps as part of the process of liver regrowth. There’s also a chance that undetected cancer cells remain in your liver after surgery.

Potential complications and side effects associated with any major surgery include:

  • Infection
  • Pneumonia
  • Reaction to general anesthesia

Getting ready for liver resection surgery

Before your operation, you’ll likely undergo imaging to determine the size and location of the tumor, and to see whether cancer also exists outside the liver. Computed tomography (CT) scans or magnetic resonance imaging (MRI) scans with contrast may be used, in addition to other tests. A CT scan may also be used to estimate the size and volume of the portion of the liver that would be left after surgery.

If the portion of the liver that would remain after a resection is deemed too small, doctors can utilize a technique to wither the cancer-bearing area while stimulating the remainder to rapidly grow. The technique, called portal vein embolization, blocks blood supply to the part of the liver with cancer. For some patients, results occur within three to four weeks. For those with diabetes or cirrhosis, an additional three to four weeks may be needed.

A short course of chemotherapy may be administered before surgery, as long courses may injure the liver. Chemotherapy may also be used for patients with metastatic tumors on both sides of the liver who undergo a two-stage hepatectomy. In those cases, a short course of chemotherapy is given, followed by a limited resection of the side of the liver with less cancer. Blood supply to the other side is then blocked to promote growth of the resected side. After recovery, a larger resection of the more affected side of the liver is performed.

You’ll meet with several members of your care team before liver surgery to go over the details of the procedure and what support you’ll need. Ask as many questions as you have during your appointments to better understand the procedure.

Recovering from liver resection surgery

Your abdomen will be sore after surgery, and you may feel numbness along the edge of your incision. You may experience gastrointestinal upset, including gas, diarrhea, constipation and nausea. You may feel tired and have a headache or a low-grade fever. Your care team can guide you on diet and what things you can or can’t do during recovery, which may last four to eight weeks.

Survival rates for liver cancer after resection

More than 42,000 Americans are expected to be diagnosed with primary liver cancer (cancers that start in the liver) in 2021, according to the American Society of Clinical Oncology, and more than 30,000 are estimated to die. Men are about three times more likely than women to face this diagnosis.

Of the primary liver cancers, hepatocellular carcinoma (HCC) is the most common. Other forms include intrahepatic cholangiocarcinoma (bile duct cancer), angiosarcoma and hemangiosarcoma (which arise from cells lining the liver’s blood vessels), and hepatoblastoma (a rare type affecting young children).

Most tumors found in the liver spread from cancer elsewhere in your body. This is called metastatic or secondary liver cancer. While these may originate from many sources, such as the lungs, breasts, pancreas or stomach, most result from colorectal cancer. About 30 percent of colorectal cancer patients develop metastatic tumors in their liver, according to a review in the journal Anticancer Research.

For people with colorectal cancer that has spread to the liver, the five-year survival rate after resection has been estimated at 25 percent to 40 percent, according to a study in International Scholarly Research Notices. This contrasts with a five-year survival rate of less than 2 percent for people whose colorectal carcinoma spread to the liver but who didn’t have a liver resection, according to a study in Surgical Treatment.

Estimates of life expectancy after a liver resection vary depending on the type of cancer, as well as other factors, such as how advanced the cancer is, your age, your general health and other treatments used.

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