Liver resection

Any potential patient requiring surgery is reviewed by a consultant in clinic, and then discussed in a multi-disciplinary meeting (MDT), where a group of relevant specialists confirm that the proposed treatment plan is appropriate.

All liver surgery is performed under general anaesthetic, often in combination with a spinal epidural. All patients will meet the anesthetist prior to the procedure, as well as seeing the surgeon for final consent.

Strategies for liver resection will depend on the site, number and size of tumours; and, for metastatic disease, the origin of the tumour. This will be planned pre-operatively by the surgical team and discussed with the patient in clinic.

Open resection is the most frequent approach to complex operations . More minor resections can occasionally be performed with minimally invasive techniques including keyhole (laparoscopic) surgey or rarely robotic surgery. Ultrasound-guided radio frequency ablation (RFA) can be considered either as an adjunct to resection, or occasionally without surgery for small central tumours.

The cut or cuts will be closed either with metal clips (removed after 10 days) or with dissolvable sutures.

You'll need to attend a pre-op assessment where you'll be asked about your general health, previous operations, allergies and any medications you're on. You may have some blood tests as well as an ECG. If necessary, an anaesthetist may also see you. All food and clear fluids must not be taken for six hours and three hours, respectively, prior to the procedure. On the day itself, your consultant and anaesthetist will come to see you before your operation. This is to ensure you fully understand what will happen, and to address any further questions or concerns you may have. Once this is concluded, you will then be asked to sign a consent form.

As liver resection is a complex surgical procedure, you will need to spend one to two nights in intensive care. You can expect to be in hospital for around seven to 10 days, sometimes longer, for monitoring.

Your pain will be controlled with patient-controlled analgesia whilst in ITU (intensive care). Some patients will have an epidural during their time in intensive care.

Whilst on the ward, pain will be controlled with intravenous and oral analgesia.

If your procedure was an open resection, you'll have a fairly large wound on the upper part of your abdomen. This will heal in one to two weeks. Full recovery however, may take eight to 10 weeks.

The resected liver tissue will be sent for analysis, and your consultant will have follow-up appointments with you to discuss histology results and plan next steps (e.g. chemotherapy) may be advised.