- Liver resection is the surgical removal of a portion of the liver. This operation is usually done to remove various types of liver tumors that are located in the resected portion of the liver.
- The goal of liver resection is to completely remove the tumor and the appropriate surrounding liver tissue without leaving any tumor behind.
What is the goal of liver resection?
- The goal of liver resection is to completely remove the tumor and the appropriate surrounding liver tissue without leaving any tumor behind. This option is limited to patients with one or two small (3 cm or less) tumors and excellent liver function, ideally without associated cirrhosis.
- As a result of these strict guidelines, in practice, very few patients with liver cancer can undergo liver resection.
- The biggest concern about resection is that following the operation, the patient can develop liver failure.
Which patients with liver cancer undergo liver resection?
- In patients with liver cancer (Hepatocellular Cancer, HCC), liver resection is limited to patients with one or two small (5 cm or less) tumors confined to the liver with no invasion of the blood vessels.
- As a result of these strict guidelines, in practice, very few patients with HCC can undergo liver resection.
- The biggest concern about resection is that following the operation, the patient can develop liver failure.
- Liver failure can occur if the remaining portion of the liver is inadequate (for example, because of associated cirrhosis) to provide the necessary support for life.
Can a portion of the remaining normal liver grow back?
- When a portion of a normal liver is removed, the remaining liver can grow back (regenerate) to the original size within several weeks.
- A cirrhotic liver, however, cannot grow back.
- Therefore, before resection is performed for HCC, the non-tumor portion of the liver should be biopsied to determine whether there is associated cirrhosis.
What are the results (survival and recurrence) of liver resection?
- For HCC patients whose tumors are successfully resected, the five-year survival is about 10% to 60%, depending on the tumor size and type.
- This means that 10% to 60% of patients who actually undergo liver resection for liver cancer are expected to live five years.
- Many of these patients, however, will have a recurrence of liver cancer elsewhere in the liver.
- Moreover, it should be noted that the survival rate of untreated patients with similar-sized tumors and similar liver function is probably comparable.
- Some studies from Europe and Japan have shown that survival rates with alcohol injection or radiofrequency ablation procedures are comparable to the survival rates of those patients who underwent resection.
- But again, the reader should be cautioned that there are no head-to-head comparisons of these procedures versus resection.
References
Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care
REFERENCES:
Brown DB, Geschwind JF, Soulen MC, Millward SF, Sacks D. Society of Interventional Radiology position statement on chemoembolization of hepatic malignancies. J Vasc Interv Radiol. 2006 Feb;17(2 Pt 1):217-23.
Bruix J, Sherman M; Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma. Hepatology. 2005 Nov;42(5):1208-36.
Garden OJ, Rees M, Poston GJ, Mirza D, Saunders M, Ledermann J, Primrose JN, Parks RW. Guidelines for resection of colorectal cancer liver metastases. Gut. 2006 Aug;55 Suppl 3:iii1-8.
Medically Reviewed by Paul Oneill, MD, Board Certified Oncology
Previous contributing medical editor: Leslie J. Schoenfield, MD, PhD
REFERENCES:
Brown DB, Geschwind JF, Soulen MC, Millward SF, Sacks D. Society of Interventional Radiology position statement on chemoembolization of hepatic malignancies. J Vasc Interv Radiol. 2006 Feb;17(2 Pt 1):217-23.
Bruix J, Sherman M; Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma. Hepatology. 2005 Nov;42(5):1208-36.
Garden OJ, Rees M, Poston GJ, Mirza D, Saunders M, Ledermann J, Primrose JN, Parks RW. Guidelines for resection of colorectal cancer liver metastases. Gut. 2006 Aug;55 Suppl 3:iii1-8.
Medically Reviewed by Paul Oneill, MD, Board Certified Oncology
Previous contributing medical editor: Leslie J. Schoenfield, MD, PhD
Complete List
Top Liver Resection Related Articles
Cirrhosis (Liver)
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections.Symptoms include yellowing of the skin (jaundice), itching, and fatigue.
The prognosis is good for some people with cirrhosis of the liver, and the survival can be up to 12 years; however the life expectancy is about 6 months to 2 years for people with severe cirrhosis with major complications.
Does Liver Cancer Spread Quickly?
Liver cancer can spread quickly depending on the type of cancer. Hemangiosarcoma and angiosarcoma types of liver cancer are fast spreading, whereas hepatocellular carcinoma spreads late in the disease.How Long Can You Live With Liver Cancer?
The overall survival rate of liver cancer patients is low, due to other underlying medical conditions, such as cirrhosis. Generally, a five-year survival rate for all stages of liver cancer is only 15%, but it can vary depending on the extent of cancer spread.
Liver (Anatomy and Function)
The liver is the largest gland and organ in the body. There are a variety of liver diseases caused by liver inflammation, scarring of the liver, infection of the liver, gallstones, cancer, toxins, genetic diseases, and blood flow problems. Symptoms of liver disease generally do not occur until the liver disease is advanced. Some symptoms of liver disease include jaundice, nausea and vomiting, easy bruising, bleeding excessively, fatigue, weakness, weight loss, shortness of breath, leg swelling, impotence, and confusion. Treatment of diseases of the liver depends on the cause.
Liver Cancer
Liver cancer is cancer of the liver cells (hepatocellular carcinoma) or of the ducts in the liver (cholangiocarcinoma). Liver cancer often arises due to liver damage, cirrhosis (scarring) caused by alcohol use/abuse, hepatitis B, or hepatitis C. Liver cancer may not cause any symptoms. Liver cancer is diagnosed with blood tests, imaging tests, and a liver biopsy. Treatment for liver cancer may include surgery, ablation, embolization, radiation, chemotherapy, and targeted therapy.
Liver Disease Quiz
What is liver disease? Take the Liver Disease Quiz and test your knowledge about this organ and its function.
Liver Picture
Front View of the Liver. The liver is a large, meaty organ that sits on the right side of the belly. See a picture of the Liver and learn more about the health topic.
Radiofrequency Ablation (RFA) of the Liver
Radiofrequency ablation (RFA) of the liver is a technique used to treat liver cancer. RFA uses imagine procedures like CT scan, ultrasound, and MRI (magnetic resonance imaging) to guide the RFA probe into the area of the tumor. There are different ways to perform radiofrequency ablation. Side effects of radiofrequency ablation of the liver are pain after the procedure, injury to the bowel, and inflammation of the gallbladder. The procedure lasts approximately 10-30 minutes.
The Digestion Process (Parts, Organs, and Functions)
Digestion is the complex process of turning the food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food. Learn more about digestion and the body parts that make it possible, including the mouth, pharynx, esophagus, stomach, small intestine, colon, rectum, anus, pancreas, liver, and gallbladder.
What Is a Hepaticojejunostomy?
The hepatic duct is the tubular channel that carries bile from the liver to the small intestine to aid digestion. A hepaticojejunostomy is a surgical procedure to make a connection (anastomosis) between the hepatic duct and the jejunum, which is the middle portion of the small intestine. This technique is called the Roux-en-Y hepaticojejunostomy.
What Is the Omentum?
The omentum ("policeman of the abdomen") is a double layer of fatty tissue that covers and supports the intestines and organs in the lower abdomen. The omentum comprises the greater omentum which is important storage for fat deposits and the lesser omentum which holds the stomach and intestines in place next to the liver and connects them via blood vessels.
What Is the Pringle Maneuver Procedure?
The Pringle maneuver is a procedure to stop the liver’s blood supply during a liver surgery. The surgeon clamps off the blood vessels leading to the liver to prevent bleeding during other liver procedures, whether for injury repair, transplant or gallbladder surgery.