Has the doctor told you or someone you know that you need to have liver surgery? It's normal to feel a little scared and nervous when you hear the word 'removing a piece of the liver'. The liver is a very important organ in our body. But if you understand it correctly , that fear can be reduced to a great extent. So today, let's talk about this surgery, which removes part of the liver, called 'hepatectomy', in a very simple way that you can understand.
Simply put, what is hepatectomy?
Hepatectomy is a surgical procedure that removes a diseased part or all of your liver. The amazing and best thing about this is that our liver has an amazing ability to regenerate itself. If the remaining part of your liver is healthy, even if you remove as much as two-thirds of it, the remaining part can grow back to its original size in a short time. Isn't that amazing?
Why is it necessary to have this kind of surgery?
There are several main reasons for this surgery. Most often, this surgery is done to remove tumors that have formed in the liver. Sometimes, this surgery is also done to donate a part of the liver to save the life of another person.
| Reason | A simple explanation |
|---|---|
| Cancerous Tumors | Remove cancers that start in the liver (Primary Liver Cancer), as well as cancers that have spread to the liver from another organ (e.g., the colon) (Secondary/Metastatic Cancer). The most common types are Hepatocellular carcinoma and Cholangiocarcinoma . |
| Benign Tumors | These are not cancerous, but they are removed because they grow in size and cause pain and discomfort. Examples include Adenoma and Liver Cysts (fluid-filled cysts in the liver). |
| Gallstones in the liver | If stones are blocking the bile ducts inside the liver and causing infection, that part is removed. |
| Living Liver Donor | A healthy person donates part of their liver to someone in need of a liver transplant. After the surgery, both livers grow back to full size. |
How serious is this surgery? Are there any risks?
To be honest, yes. This is considered a technically complex and difficult surgery . The main reason is that the liver is an organ with a rich blood supply. Therefore, the risk of bleeding during the surgery is high. For this reason, these surgeries are performed by surgeons who have special training and experience in this field.
The risks of surgery depend on the size of the liver section removed and the overall health of your liver.
- Minor Resection: If less than half of the liver is removed, the risks are low. These are often performed using 'keyhole' surgery (laparoscopic surgery) or robotic surgery .
- Major Resection: If more than half of the liver is removed, the surgery becomes more complex and risky.
Therefore, if you are going to have this type of surgery, it is very important to choose a specialist with good experience and a hospital with facilities .
What happens before the surgery?
Before performing surgery on you, the doctor will carefully examine several factors.
Things the doctor considers
- Is your physical health strong enough to withstand such a major surgery?
- Is there a place in the liver where the tumor can be surgically removed?
- If it is cancer, has it spread to other areas outside the liver?
- Is the remaining liver part after surgery sufficient to continue the body's functions?
To confirm these things, your doctor will ask you to do some tests.
- Imaging Tests: A CT scan or MRI scan .
- Blood tests (Liver Function Tests): Measure liver function.
- Liver Biopsy: Taking a small piece of tissue from the liver for examination.
Sometimes, radiation therapy or chemotherapy may be given before surgery to reduce the size of the cancer and make surgery easier and safer.
What are the methods of performing the surgery?
There are two main methods: Open Surgery and Minimally Invasive Surgery.
| Surgical method | Description |
|---|---|
| Open Surgery | The surgery is performed by opening the abdominal cavity through a single long incision in the abdomen. This method is best for removing complex and large tumors. |
| Laparoscopic/Robotic Surgery | The surgery is performed through 4-6 small incisions, with a camera and special instruments inserted. The incisions are small, so there is less pain, faster healing, and smaller scars. |
What happens after the surgery? How long does it take to recover?
After surgery, you may be kept in the intensive care unit (ICU) for a day or two. You will have drains to remove fluids from your body and feeding tubes. As you recover, you will be transferred to a regular ward.
- Hospital stay: Usually, you will have to stay in the hospital for about a week.
- Recovering at home:
- If you had open surgery, it can take between 4 and 8 weeks to fully heal.
- If it is a keyhole surgery, recovery can take between 2 and 4 weeks .
- Important: Avoid heavy lifting or strenuous exercise completely during this time. Taking a short walk every day will help the healing process.
Risks/Complications of surgery
As with any surgery, there are risks and complications that can occur. It is important to be aware of these.
- Infection: Infections can occur in the surgical wound, lungs, or urinary tract.
- Bleeding: A major risk of liver surgery. A blood transfusion may be required.
- Bile Leakage: If a bile duct is damaged during surgery, bile can leak into the abdomen.
- Kidney Failure: In some cases, kidney function may be affected.
- Liver Failure: A very serious condition that can occur if the remaining part of the liver does not function adequately.
- Blood clots (Deep Vein Thrombosis): There is a risk of blood clots in the legs due to prolonged bed rest after surgery.
Your doctor will explain these risks to you in more detail.
Warning signs that require a visit to the doctor
If you experience any of the following symptoms after going home after surgery, inform your doctor immediately or go to the hospital's Emergency Department (ETU) .
Be very aware of these symptoms. Prompt treatment can prevent serious conditions.
- Persistent fever lasting several days.
- Bleeding from a surgical wound, such as blood or pus .
- Persistent vomiting or diarrhea .
- To show a bloated, bloated appearance .
- Yellowing of the eyes and skin (Jaundice) .
- Constipation lasting more than three days.
Liver surgery is a big deal. But when done with the right medical team and a well-planned plan, it can give you or your liver donor a new lease of life. Especially for cancer patients, it can be the best treatment that can save their lives.
Take-Home Message
- Hepatectomy is a major surgery that removes part of the liver. But it can cure diseases like cancer and save lives.
- Our liver has an amazing ability to regenerate itself. The remaining healthy part will eventually return to its normal size.
- The healing process takes time, so be patient and follow your doctor's instructions exactly.
- Avoid alcohol completely after surgery. It is very harmful to the liver.
- If you notice any unusual symptoms, such as fever, wound drainage, or yellowing of the eyes, inform your doctor without delay.
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