You have a tumour or some other condition which requires part of the liver to be removed. Although the liver looks like one organ, for technical purposes we can divide the liver into 8 parts.
We can remove each part on its own or with others depending on the location of the tumours in the liver.
We can survive with just 20 to 30% of the liver. This allows the surgeon to remove as much as 80% of the liver if necessary without any problems. The liver has a very good capacity to grow back (regenerate).
We will explain to you which parts of the liver he/she proposes to remove and why. There may be occasions where the surgeon may have to remove more liver because of the findings during the operation. They will proceed if this is to your benefit and if they can leave behind enough liver, to survive. The operation is done through a large incision on the top of the abdomen.
Potential Complications after liver surgery
Liver is an organ full of blood and there is a risk of severe bleeding while cutting the liver. We use special techniques to cut the liver which reduces the risk significantly. We do not give blood transfusion most of the time as bleeding is not much during the operation. However bleeding remains the most serious risk during the operation which on some occasions can be life threatening.
Bile can leak from small bile ducts on the cut surface of the liver. This complication occurs infrequently. If it happens it settles most of the time without any further therapy. However the hospital stay may be prolonged. On some occasions we have to perform an endoscopy (a tube with camera passed via the mouth) to place a stent (small tube) in the main bile duct.
Liver failure may occur if the amount of liver left behind is not enough. If this happens you may lose conciousness, become jaundiced and develop a bleeding tendency. This is a serious complication for which supportive therapy is given until the liver function recovers. This complication has a high risk of death following the operation.
There is a risk of this complication as patients may not be able to breathe deeply due to pain in the operation wound. The secretions stay in the lungs leading to an infection. The risk can be reduced by taking deep breaths a few times every hour and coughing to bring up phlegm. The doctor will ensure that pain relief is adequate.
There is a risk of infection developing within the abdomen, in the wound or in the urine. Most of these can be treated with antibiotics.
The following complications can happen after any major operations and are true for liver surgery as well; Heart attacks, pulmonary embolism (clot in the lung). These are serious complications which can lead to death.
How long will the operation take?
Liver operations are complicated and major operations. The exact time depends on the type of liver resection. The anaesthetic doctor will take around an hour and a half to prepare you for the operation. After this, the operation, on an average, takes about 6 hours. However some operations can take as long as 12 to 15 hours.
Where will I go from the operating theatre?
You will usually go to the ICU after the operation. On some occasions the anaesthetic doctor may want you to be on the machine to help with your breathing for a few hours. Patients normally stay in the ICU for about 12 to 16 hours. You will then be transferred to the surgical ward.
When can I eat after the operation?
You should be able to drink small amounts of water on the first day after the operation. If you tolerate that well you will be allowed to drink more later that day. You will be allowed to have some soft diet on the second day. Most patients are able to eat normal diet in about 3 or 4 days after the operation.
How long will I stay in the hospital?
The average hospital stay, after the operation, for most patients is around 5-6 days. The stay may be prolonged if there is any complication after the operation.
When can I drive after the operation?
You will be able to drive in about 6 to 8 weeks after the operation.
Can I drink alcohol after going home?
It is wise to avoid any alcohol for at least 3 months after liver resection. This is the time when the liver will be regenerating. After this period you may take alcohol in moderation (the usual maximum weekly allowance)