Surgery for primary liver cancer
The aim of surgery is to remove all the cancer from the liver, as well as a margin of healthy tissue. This is known as a liver resection or partial hepatectomy. Your surgeon will talk to you about the most appropriate surgery for you, as well as the risks and any possible complications.
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Who it’s suitable for
Only a small number of people with liver cancer can have this surgery and it is usually done in specialist centres. The liver has to be working well because it needs to repair itself after the surgery. This means that people with no or early cirrhosis may be considered for surgery, but it is unlikely that people with more advanced cirrhosis will be offered surgery.
Types of surgery
Depending on the cancer’s size and position, the liver resection may be called a right or left hepatectomy (removes the right or left part of the liver), extended right or left hepatectomy (removes most of the liver), or segmentectomy (removes a small section of the liver). Sometimes the gall bladder may also be removed, along with part of the muscle that separates the chest from the abdomen (the diaphragm).
How the surgery is done
If you have a liver resection, it will be carried out in hospital under a general anaesthetic. Most operations for primary liver cancer are done through a large cut in the upper abdomen. This is called open surgery.
Some liver tumours are removed using keyhole (laparoscopic) surgery. The surgeon will make a few small cuts in the abdomen, then insert a tiny instrument with a light and camera (laparoscope) into one of the cuts. The surgeon inserts tools into the other cuts to remove the cancerous tissue, using images from the camera as a guide.
People who have laparoscopic surgery usually have a shorter stay in hospital, less pain and a faster recovery time. However, laparoscopic surgery is not suitable for everyone and is not available in all hospitals. Talk to your surgeon about the best option for you. Whether you have open or laparoscopic surgery, a liver resection is a major operation.
After the surgery
The portion of the liver that remains after the resection will start to grow, even if up to three-quarters of the liver has been removed. It will usually regrow to its normal size within a few months, although its shape may be slightly changed.
- bleeding is a risk because a lot of blood passes through the liver – 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) – this is usually temporary and improves as the liver grows back
- most people will need a high level of care – you will spend 5–10 days in hospital after a liver resection and it is common to spend some time in the high dependency unit or intensive care unit before moving to a standard room.
Learn more about recovering after surgery.
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Dr David Yeo, Hepatobiliary/Transplant Surgeon, Royal Prince Alfred, Chris O’Brien Lifehouse Cancer Centre and St George Hospitals, NSW; Dr Lorraine Chantrill, Head of Department Medical Oncology, Illawarra Shoalhaven Local Health District, NSW; Michael Coulson, Consumer; Dr Sam Davis, Interventional Radiologist, Staff Specialist, Royal Brisbane and Women‘s Hospital, QLD; Prof Chris Karapetis, Network Clinical Director (Cancer Services), Southern Adelaide Local Health Network, Head, Department of Medical Oncology, Flinders Medical Centre and Flinders University, SA; Dr Howard Liu, Radiation Oncologist, Princess Alexandra Hospital, QLD; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Lina Sharma, Consumer; Dr Graham Starkey, Hepato-Biliary and General Surgeon, Austin Hospital, VIC; Catherine Trevaskis, Gastrointestinal Cancer Specialist Nurse, Canberra Hospital and Health Services, ACT; Dr Michael Wallace, Western Australia Liver Transplant Service, Sir Charles Gairdner Hospital, WA.
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