Hepatectomy, also known as liver resection is a surgery to remove all or part of the liver.
Some facts about Hepatectomy:
- The liver can grow back to its former size if you have part of your liver removed. But, you will need a liver transplant if you have a total hepatectomy.
- Up to two-thirds of your liver can be removed as long as the rest of your liver is healthy.
- A smaller portion may be removed if you have liver disease.
- It will grow back to its former size if your remaining liver is healthy.
- Hepatectomy is done to treat liver disease, or when you want to donate part of your liver for living donor liver transplantation.
- A partial liver resection will be performed to remove a cancerous, precancerous or benign (noncancerous) tumor which can be primary or secondary.
- Hepatocellular carcinoma (primary liver cancer), Cholangiocarcinoma (primary liver cancer) and Metastatic colorectal cancer (secondary liver cancer) can be treated by partial hepatectomy.
Preparation for Hepatectomy:
- Avoid eating and drinking anything at least four hours before your surgery.
- You may drink a sip of water with your medications if needed.
- Any history of bleeding disorders or are taking any blood-thinning (anticoagulant) medicines, aspirin, or other medicines that affect blood clotting should be informed to your healthcare provider as you may be asked to stop taking these medicines before your surgery.
- The possible complications and side effects, the risks, and what the operation involves will be discussed with you by your doctor.
- Radiation therapy, interventional radiology or chemotherapy may be done before surgery in some cases to reduce the cancer size, make the operation easier and safer, or improve the chance of curing cancer.
- It will be decided by your healthcare provider whether a partial hepatectomy or a liver transplant is needed depending on how extensive the tumor is, how healthy your liver is, how much functional liver can be left after resection and whether you qualify for a transplant.
Procedure for Hepatectomy:
- Hepatectomy can be performed either by open, laparoscopic or robotic surgery.
- The best method to manage your condition will be determined by your surgeon.
- Laparoscopic and robotic surgeries are less invasive as they are done through smaller incisions.
- Usually four to six small incisions, each about a half-inch in size will be made during a Laparoscopic surgery which make for an easier and quicker recovery.
- Traditional open surgery can be performed to manage more extensive or complicated liver resections.
- Your abdominal cavity will be open up by a long incision called a laparotomy in open abdominal surgery.
- Your abdomen can be visualized directly by the surgeon.
- The entire operation takes place through small keyhole incisions while your surgeon looks at the images from the camera on a screen during laparoscopic surgery
- Specially designed, long instruments will be used to complete your liver resection.
- Robotic arms can also be used.
- Laparoscopic or robotic approach can be used for less complex liver resections as movement is somewhat restricted.
- However, more complex surgeries such as major liver resection or living donor liver resections are now possible through a laparoscopic or robotic approach with the development of surgical techniques.
- The diseased part of your liver with a safe margin around any cancerous tumor can be removed while leaving enough liver behind to keep up with all the work your liver has to do in a partial Hepatectomy.
- The right or left lobe (hemiliver) will be removed in right or left hepatectomy or lobectomy.
- Segment or a part of a segment with a tumor with a margin around it will be removed in Segmental or wedge resection.
