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Liver resection

Patients undergoing liver resection of primary or secondary tumours

Which patients are considered for liver surgery?
Any patient with a primary liver tumour in whom the tumour can be removed with clear margins, is potentially suitable for liver surgery, provided there is no evidence of spread outside the liver. Patients with secondary liver tumours will often have had the primary tumour removed before seeking advice about the secondary liver tumours. In some circumstances, particularly for patients with secondary tumours from a primary tumour in the colon, liver surgery to remove the tumours is associated with improved survival. Patients with secondary tumours from a neuroendocrine tumour, breast tumour, kidney tumour, melanoma, ovarian and testicular tumours, can be considered in selected cases for liver surgery.

What happens in a liver operation?
Liver operations are performed under general anaesthetic. The part of the liver affected by the primary or secondary tumour is removed, with up to 70% of the liver being removed in some patients. The liver left behind will regrow (regenerate) during the weeks after the operation. Liver resection is a major operation with a predicted inpatient stay after surgery of 7-10 days. After surgery patients will often have an epidural catheter for pain relief, a urinary catheter, and an intravenous drip for fluid replacement. Up to 20% of patients may be suitable for a keyhole (laparoscopic) operation to remove their liver tumour, the remaining patients however will need open surgery.

Is liver surgery safe?
Liver surgery is now routinely performed in specialist liver centres throughout the UK. The results of liver surgery have improved dramatically over the past two decades and it is now regarded as a safe operation in specialist hands. Surgeons should be able to indicate the number of procedures they have performed and their operative figures for these patients. An operative mortality rate of less than 3% for major liver surgery is expected, and patients return to full activity after surgery in 6-8 weeks. Post operative complications including chest, urine and wound infections, bile leaks and liver failure may occur in up to 20% of patients. Blood loss during liver surgery is usually less than one litre and blood transfusion is only needed in 25% of patients.

What are the benefits of surgical removal of the tumours? The aim of surgical resection of secondary and primary liver tumours is to remove all of the cancer deposits with clear margins. Liver resection has been shown in selected patients, to improve the chances of long term survival and in some cases patients can be cured.

Will I need further treatment after my liver operation?
This is dependent on the results of the liver surgery and the type of tumour removed. Every patient will have an individual treatment plan after discussion between their liver surgeon and oncologist. Some patients may benefit from chemotherapy, radiotherapy or hormone therapy after their liver operation.

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