Doctors may use CT or MRI scans to plan a surgery. These imaging studies provide detailed views of the tumour, liver, surrounding blood vessels, and other structures that can help doctors pinpoint the location of the tumour or tumours before the procedure.
Liver resection can either be performed by an open surgery or laparoscopic surgery.
Open surgery: May be recommended for large tumours or those that are located deep within the liver. In an open procedure, surgeon makes an incision that is several inches long across the right side of the abdomen, just below the ribcage. Surgeon will carefully dissect the section of liver that is to be removed from the many veins, arteries and bile ducts that support it.
Laparoscopic surgery: In some situations, it may be possible to have keyhole (laparoscopic) surgery to remove the affected part of the liver. Several small cuts (incisions) are made instead of one large cut. Generally about three small cuts and one larger cut are needed. At Island Hospital, we also use minimally invasive laparoscopic surgery for some patients with liver tumors. It is now becoming more common for liver tumours to be removed with several smaller cuts.
Surgeon will insert a tiny tube with an eyepiece at one end, and a light and a magnifying lens at the other (laparoscope) into one of the cuts and will remove tissues with the tool at the end of the laparoscope.
People who have laparoscopic surgery usually have much smaller wounds, so you have less pain, a faster recovery time and shorter hospital stay. However, laparoscopic surgery is not suitable for everyone if the size and/or number of tumours would make the operation too complex to be carried out.
Most liver resections include removing your gallbladder because it is in the middle of your liver and it is often attached to the piece of liver that needs to be removed.
You can live with only a part of your liver working. When a portion of the liver is removed, the remaining liver can grow back (regenerate) if your liver is healthy. This growth occurs over 6-8 weeks. Although its shape will be different, you will not notice any difference.
This regeneration does not occur for patients with cirrhosis of the liver or an otherwise unhealthy liver. Good nutrition with a high-protein diet is important for liver regeneration.
It will be some time before you regain the energy you had before the operation. It is important to be aware that it may take weeks and even some months before you feel completely fit again. Rest as much as possible, gradually increasing your level of activity as soon as you feel comfortable.
Liver surgery can be complex, because the organ contains many important blood vessels. For example, after the portal vein brings blood to the liver, the blood leaves the organ through hepatic veins to the major vein in the abdomen that returns blood to the heart. Island Hospital surgeons are skilled in removing cancer while protecting important arteries and veins, preserving as much healthy tissue as possible.