What is Liver Resection? Causes, Procedure, Cost

October 27, 2023 Liver Section 73 Views

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Liver resection , also known as hepatectomy, is a surgical procedure in which a portion of the liver is removed. This is typically done to treat conditions such as liver tumors, including cancerous and non-cancerous growths. 

The extent of the resection depends on the size and location of the tumor, and the goal is to remove the affected part while leaving enough healthy liver tissue to maintain essential liver functions. 

It’s a complex procedure often performed by a skilled surgeon and may involve open surgery or minimally invasive techniques like laparoscopy. Patients must be carefully evaluated to ensure they can tolerate the loss of liver tissue, and recovery can take several weeks.

What conditions require liver resection surgery?

Liver resection is typically performed to treat various liver conditions, including:

  • Liver Cancer: The most common reason for liver resection is to remove liver tumors, which can be either primary liver cancer (hepatocellular carcinoma) or secondary cancer that has spread to the liver (metastatic cancer).
  • Benign Liver Tumors: Non-cancerous liver tumors, such as hemangiomas, adenomas, or focal nodular hyperplasia, may require resection if they are large, symptomatic, or at risk of rupture.
  • Liver Cysts: Large liver cysts, particularly those causing symptoms or complications, may be treated with resection.
  • Trauma: Severe liver injuries resulting from accidents or trauma can necessitate resection to control bleeding and repair the damaged tissue.
  • Liver Abscess: In cases of a liver abscess, where pus accumulates in the liver due to infection, surgical drainage or resection may be required.
  • Infection: Rarely, severe liver infections that don’t respond to other treatments may require surgical removal of affected tissue.
  • Liver Donor Surgery: In living donor liver transplantation, a portion of a healthy donor’s liver is resected for transplantation into a recipient.

The specific need for liver resection depends on the individual’s medical condition, the location and size of the lesion, and the extent of liver function that can be preserved. The decision for surgery is made after a thorough evaluation by medical professionals. ( Know more about- What are Liver Diseases ? )

Is Liver Resection Surgery part of liver transplant surgery procedure?

Liver resection and liver transplant are two distinct surgical procedures, but they can be related in certain situations:

  • Liver Resection: Liver resection is the removal of a portion of the liver while leaving the rest of the liver intact. It is typically performed to treat conditions like liver tumors, benign growths, or other localized liver diseases, with the aim of preserving as much healthy liver tissue as possible.
  • Liver Transplant: Liver transplantation involves replacing a patient’s entire liver with a healthy liver from a deceased or living donor. It is typically performed in cases of end-stage liver disease, severe liver failure, or unresectable liver tumors. The patient’s entire liver is removed, and a new liver is transplanted in its place. ( Know more about- What is Liver Transplant Surgery ? )

However, there is a connection between the two procedures in the context of living donor liver transplantation (LDLT). In LDLT, a living donor, typically a family member or close relative, donates a portion of their liver to the recipient. This living donor surgery involves a liver resection, as a segment of the donor’s liver is removed for transplantation into the recipient. 

Subsequently, both the donor and the recipient undergo surgical procedures, but they serve different purposes within the context of liver transplantation.

What are types of Liver Resection Surgery?

There are several types of liver resection surgeries, and the choice of procedure depends on the location and extent of the liver disease, as well as the patient’s overall health. The main types of liver resection surgeries include:

  • Wedge Resection: This is the removal of a small, wedge-shaped portion of the liver. It’s typically used for small tumors or lesions located near the surface of the liver.
  • Segmental Resection: A larger portion of the liver is removed, often involving a complete segment of the liver. This is common for tumors or diseases that affect a specific segment of the liver.
  • Hemihepatectomy: In a hemihepatectomy, one of the liver’s two main lobes (the right or left lobe) is partially or completely removed. This procedure is used for larger tumors or extensive liver disease.
  • Trisegmentectomy: This is the removal of three segments of the liver. It’s a more extensive procedure used for larger tumors or advanced liver diseases.
  • Extended Hepatectomy: In cases of extensive disease or multiple tumors, an extended hepatectomy may be performed, involving the removal of more than half of the liver.
  • Living Donor Hepatectomy: In living donor liver transplantation, a healthy donor undergoes a hepatectomy to remove a portion of their liver for transplantation into the recipient. This procedure is tailored to ensure both the donor and recipient have functional liver remnants.

The specific type of liver resection is determined by the surgeon based on the patient’s condition and the location and size of the liver lesion. 

Is liver biopsy a type of liver resection surgery?

A liver biopsy is not a type of liver resection; these are two distinct procedures used for different purposes.

  • Liver Biopsy: A liver biopsy is a diagnostic procedure in which a small sample of liver tissue is removed for examination under a microscope. It is typically performed to diagnose various liver conditions, including liver diseases, inflammation, fibrosis, or the presence of tumours. A biopsy helps doctors determine the nature and severity of the liver condition without removing any significant portion of the liver. It can be done through a needle biopsy (percutaneous or transjugular) or during surgery, depending on the specific clinical situation. ( Know more about- What is Liver Cancer ? )
  • Liver Resection: Liver resection, on the other hand, involves the surgical removal of a portion of the liver. This procedure is typically used to treat localized liver tumors, remove benign growths, or address certain liver diseases by removing the affected area while preserving the remaining liver tissue.

A liver biopsy is a diagnostic procedure, whereas liver resection is a therapeutic surgery. The decision to perform either of these procedures depends on the patient’s condition and the specific medical goals.

What is the procedure of liver resection surgery ?

The procedure for liver resection surgery involves several steps:

  • Preparation: Before the surgery, the patient is typically evaluated through various tests, including imaging studies (such as CT scans or MRI) and blood tests. The medical team assesses the patient’s overall health and liver function to determine the suitability for the procedure.
  • Anesthesia: The patient is given general anesthesia to ensure they are unconscious and pain-free during the surgery.
  • Incision: The surgeon makes an incision in the abdomen, which provides access to the liver. The size and location of the incision can vary depending on the specific surgical approach used.
  • Liver Isolation: The liver is carefully isolated and temporarily blocked from blood flow to reduce bleeding during the surgery. This can be done using clamps or other techniques.
  • Resection: The surgeon removes the portion of the liver that contains the tumor, lesion, or affected area. The extent of resection depends on the location and size of the liver disease and the goal of preserving as much healthy liver tissue as possible.
  • Hemostasis: The surgical team ensures that any bleeding from the cut liver tissue is controlled and stopped. This can involve using sutures, staples, or special coagulation techniques.
  • Closure: After the resection is complete and bleeding is controlled, the surgeon closes the incision with sutures or surgical staples.
  • Postoperative Care: The patient is closely monitored in a recovery area as they wake up from anesthesia. Afterward, they are typically transferred to a hospital room for further recovery.

Recovery from liver surgery can take several weeks, and the patient’s liver function should be closely monitored during this time. Patients must follow their doctor’s post-operative care instructions, including dietary guidelines and activity restrictions, to ensure a successful recovery.

The specific details of the procedure may vary depending on the patient’s condition, the location and extent of the liver resection, and the surgical approach chosen by the medical team. It’s a complex surgery that requires the expertise of a skilled surgical team.

What can be the complications of liver resection surgery? How can we prevent these complications?

Liver resection is a major procedure, and while it can be effective in treating liver conditions, it does carry some potential complications. Common complications can include:

  • Bleeding: This is a primary concern during liver resection. Surgeons take steps to control bleeding during the procedure, but postoperative bleeding can occur. ( Know more about- What is Blood in Stool ? )
  • Infection: As with any surgery, there is a risk of postoperative infection at the incision site or within the abdomen.
  • Liver Failure: There is a risk of temporary or even permanent liver dysfunction following a resection, particularly if a significant portion of the liver is removed.
  • Bile Leak: Sometimes, the bile ducts can leak bile into the abdominal cavity, which may require additional treatment or drainage.
  • Fluid Accumulation: Fluid may accumulate in the abdominal cavity, a condition known as ascites, which can be uncomfortable and may require drainage.
  • Blood Clots: The risk of deep vein thrombosis (DVT) and pulmonary embolism (PE) is increased after surgery due to reduced mobility.
  • Respiratory Complications: Breathing problems can occur, especially after more extensive surgeries, as a result of general anesthesia and limited mobility.

To help prevent complications and aid in recovery:

  • Follow Medical Advice: Adhere to your healthcare provider’s instructions regarding post-operative care, medications, and dietary restrictions.
  • Gradual Resumption of Activities: Slowly resume normal activities as advised by your medical team to prevent strain on the surgical site.
  • Prevention of Blood Clots: Take measures to prevent blood clots, such as early mobilization, compression stockings, and blood-thinning medications.
  • Nutrition: Maintain a healthy diet to support liver regeneration and healing. Your healthcare team will provide dietary guidelines.
  • Hygiene: Keep the surgical site clean and dry to prevent infection.
  • Regular Follow-Up: Attend scheduled follow-up appointments to monitor your recovery and liver function.

Communicate any unusual symptoms or complications to your surgeon promptly. Liver surgery should be performed by skilled surgeons in a well-equipped medical facility, which can reduce the risk of complications. 

What is the cost of liver resection surgery in India ?

The cost of liver resection surgery in India can vary significantly depending on several factors, including the specific hospital or medical facility, the location within India, the surgeon’s expertise, the extent and complexity of the procedure, and the type of room and services chosen for recovery. 

Generally, the cost of liver resection surgery in India can range from approximately ₹3,00,000 to ₹8,00,000 or more. This estimate covers the surgical procedure, hospital stay, anesthesia, medical tests, surgeon’s fees, and post-operative care. Medical insurance may also play a role in covering some of the costs, so it’s advisable to discuss your insurance coverage and options with your hospital before the surgery. Get liver resection and liver transplant surgery done at the best hospital H N Reliance Hospital Mumbai.

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