Surgery for secondary liver cancer
The aim of surgery is to remove the part of the liver that contains cancer. This is known as liver resection or partial hepatectomy. It is the most effective treatment, but it is only possible if there is enough healthy liver and the cancer hasn’t spread to other parts of the body where it can’t be removed (such as the bones). Some people need surgery for both the secondary cancer in the liver and the primary cancer. These operations may be done separately or at the same time.
A liver resection is a major operation. You will have a general anaesthetic and the surgeon will remove the tumour as well as some healthy-looking tissue around it. The operation may be done as open surgery (with one large cut) or as keyhole or laparoscopic surgery (with several smaller cuts).
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Types of liver resections
There are different types of liver resections depending on the size and position of the cancer. The diagrams below show the front view, so the right part of the liver appears here on the left, and vice versa.
Sometimes the gall bladder may also be removed, along with part of the diaphragm (the sheet of muscle that separates the chest from the abdomen).
Removes the right part of the liver
Removes the left part of the liver
|Extended left hepatectomy|
Removes most of the liver, leaving a portion on the right
Removes a small section of the liver
After the surgery
The liver can repair itself easily if it is not damaged already. The part of the liver that remains after resection will start to grow, even if up to three-quarters of it is removed. The liver will usually regrow to its normal size within a few months, although its shape may be slightly changed. When a very large the liver needs to be removed, you may need a procedure called a portal vein embolisation (PVE) 4–8 weeks before the surgery.
Because a lot of blood passes through the liver, bleeding after surgery is a risk. Your medical team will monitor you for signs of bleeding and infection.
Some people experience jaundice (yellowing of the skin and whites of the eyes) after a liver resection. This is usually temporary and improves as the liver grows back.
You will spend 5–10 days in hospital after a liver resection. See Surgeryfor more information about recovery after surgery.
People with tumours in both lobes of the liver sometimes need surgery that is carried out in two stages with a waiting period between them.
Stage 1 – The tumours are removed from one lobe of the liver (partial hepatectomy). Sometimes this surgery is combined with tumour ablation or removal of the original cancer.
Waiting period – After the first surgery, you will need to wait two months to allow your body to recover and the liver to regrow. Before you have the second operation, the size of your liver will be checked.
Stage 2 – If enough of the liver has regrown, the tumours in the second lobe of the liver will be removed with another partial hepatectomy.
Video: What is surgery?
We thank the reviewers of this booklet: A/Prof Nicholas O’Rourke, University of Queensland, and Head of Hepatobiliary Surgery, Royal Brisbane and Women’s Hospital, QLD; Dr Lorraine Chantrill, Senior Staff Specialist Medical Oncology, The Kinghorn Cancer Centre, St Vincent’s Hospital, Sydney, and Honorary Research Fellow, Garvan Institute of Medical Research, NSW; A/Prof Mark Danta, Hepatologist, St Vincent’s Hospital, Sydney, and St Vincent’s Clinical School, Faculty of Medicine, The University of New South Wales, NSW; Dr Samuel Davis, Diagnostic and Interventional Radiologist, Qscan Radiology Clinics and Royal Brisbane and Women’s Hospital, QLD; David Fry, Consumer; Dr Nigel Mott, Diagnostic and Interventional Radiologist, Wesley Hospital and Royal Brisbane and Women’s Hospital, QLD; Chris Rivett, 13 11 20 Consultant, Cancer Council SA; Meg Rogers, Nurse Coordinator, Upper Gastrointestinal Service, Peter MacCallum Cancer Centre, VIC; A/Prof Simone Strasser, Senior Staff Specialist, AW Morrow Gastroenterology and Liver Centre and Australian National Liver Transplant Unit, Royal Prince Alfred Hospital, Sydney, and Central Clinical School, Sydney Medical School, University of Sydney, NSW. We would also like to thank the health professionals and consumers who have worked on previous editions of this title. Some of the information from previous editions of this booklet was sourced from Macmillan Cancer Care, UK. This booklet is funded through the generosity of the people of Australia.
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