Liver resection: the removal of part of the liver

The liver has a unique regenerative capacity. If necessary, a surgeon can remove part of the liver. The liver then has the ability to grow back to its old volume within a few weeks. This makes the liver a unique organ. Partial removal of the liver is called a liver resection.

The liver

The liver is the largest organ in the body. The liver weighs approximately 1.6 kilos in men and 1.3 kilos in women. The liver occupies the upper right side of the body. The liver extends from the navel to the left nipple. The liver performs many functions. The liver removes toxins from food in the digestive system. The liver is also a storage container for vitamins. For example, the liver can on average store enough vitamin A for ten months and even enough B12 for three years. The liver can also store large amounts of folic acid, iron and copper. The liver also secretes toxins such as alcohol and drugs. In addition, the liver also has important metabolic functions. For example, the liver ensures that the glucose level in the blood remains at a certain level.

Tumors and cysts in the liver

A maximum of 75 percent of a liver can be removed. The liver usually continues to function properly and grows naturally. For example, in the case of tumors and cysts in the liver, liver lobes containing cancer cells can be removed without any problems. Tumors in the liver should first be mapped using ultrasound, MRI and CT scans. A liver resection is usually performed in university hospitals.

When a liver resection is performed

A tumor in the liver is usually only removed if it is a primary cancer. A metastasis in the liver is called secondary cancer and can almost never be removed. In the case of a benign tumor, resection is only performed if the tumor is large or causes oppression of other organs. Patients with liver cirrhosis (shredding of the liver) are in most cases not eligible for liver resection. Liver cirrhosis causes the liver to no longer function one hundred percent. To be eligible for a liver resection, the remainder of the liver (the remaining part of the liver) must have good blood flow, good bile drainage and a capacity of at least 25 percent of the original volume.

Preparations for the operation

In addition to scans, doctors will also perform tests on the heart and lungs to see if the patient is physically strong enough to handle a liver resection. In most cases, hospital admission takes place one day in advance. The operation is performed under anesthesia and takes six to eight hours.

The operation

A liver resection is a major operation. The surgeon cuts open the abdominal cavity up to the upper abdomen. Sometimes part of the chest is also opened. During a liver resection, a small part can be removed, but also a large part. This varies per patient. To cut away part of the liver, various veins and bile ducts must first be tied off. The surgeon works extremely carefully to prevent bleeding as much as possible. When part of the liver is removed, cell tissue from the liver is cut away. Veins and bile ducts are also tied off. Small barrels are burned shut. This way, bleeding can be prevented. Once the liver resection is completed, the surgeon uses special glue to prevent bleeding. After the operation, a drainage tube is inserted to treat bleeding and bile leakage as quickly as possible.

After the operation

95 percent of patients recover after surgery. Complications such as bleeding or bile leakage occur in approximately five percent. Patients spend an average of one week in the hospital after surgery. Eating and drinking is usually allowed within a day. Complete healing takes at least two months. In most cases it is more.

Complications

In the event of bleeding or bile leakage, it may be necessary to intervene via a visual examination or a puncture under a CT scan. In rare cases, surgical intervention is required. Sometimes the patient becomes short of breath after the operation. Then there is fluid accumulation next to the lung. This complication can occur if the surgeon separates the liver from the diaphragm. The fluid accumulation is remedied with medication or a puncture. After a liver resection, it may also appear that the remainder of the liver is not yet functioning properly, resulting in liver failure. This usually disappears once the liver begins to grow to its original capacity.

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