Every patient with a liver tumor should be evaluated for a resection. It is the only chance for cure. Removing the tumor will rid the body of the cancer and also prevent further spread to other regions. Unfortunately, not all patients are eligible for a liver resection.
The liver is a privileged organ in that it has the ability to regenerate if part of it is removed and this allows surgeons to operate upon it successfully. In patients with colon cancer that has spread to the liver, liver resection can cure 25 – 45% of the patients. Patients may also develop metastatic colorectal cancer to both the lungs and liver. In select patients, simultaneous resection of metastases from the lung and liver can provide significant benefit.
Other indications for liver resection are metastases from other sites such as breast, kidney, lung, selected tumors of the pancreas and small intestine and sarcomas. Although these diagnoses are controversial indications, 2 year survival rates of 90% have been obtained. This improved survival occurs in patients who respond to chemotherapy and have disease only in the liver. Other indications for resection are tumors that originated in the liver, called hepatocellular cancer and cholangiocarcinoma.
A variety of liver resections can be performed. The options range from resection of a lobe (left or right) to segments (or small portions) of the liver. Resection of segments of the liver (called segmentectomy) permits a surgeon to effectively treat multiple liver tumors.
How Long will the surgery last and what is the usual length of stay in hospital?
A liver resection can take 4 – 6 hours to perform. In the majority of patients, a liver resection does not require a blood transfusion. The patient will be able to drink fluids on the second post-operative day and often is discharged in 8 – 10 days. The patient will be able to drink fluids on the first post-operative day and often is discharged in 4 – 6 days if the hepatectomy is performed laparoscopically as laparoscopic hepatectomy or keyhole surgery liver resection.
The author performed the first in house laparoscopic hepatectomy at NationalUniversity Hospital in Singapore paving the way for establishment of advanced laparoscopic hepatobiliary surgery.