Partial liver removal, known as a hepatectomy or liver resection, involves precisely removing diseased or damaged sections. This procedure is possible due to the liver’s remarkable ability to recover and regenerate. It is considered for various conditions, aiming to preserve enough healthy liver tissue to maintain its essential functions.
The Liver’s Regenerative Capacity
The liver possesses a remarkable ability to regenerate. Unlike most other organs, it can regrow its mass and function even after a significant portion is removed. This regenerative power is central to why hepatectomy is possible.
Surgeons can typically remove a substantial part of the liver, often up to 70% to 80% of its volume, especially if the remaining liver tissue is healthy. In cases where the liver has pre-existing damage, such as from certain diseases, the safe removal percentage might be less, possibly around one-third. The remaining liver tissue then begins to enlarge, restoring the organ to nearly its original size and functional capacity within a few months.
This regenerative process involves the remaining liver cells, called hepatocytes, multiplying to compensate for the lost tissue. This ability to restore itself is a key factor in the long-term success and safety of partial liver removal procedures, ensuring the body can continue its vital functions.
Conditions Requiring Partial Removal
Partial liver removal, or hepatic resection, is necessary for medical conditions primarily involving tumors or severe localized damage. The most frequent reason is cancerous growths within the liver, including primary liver cancers like hepatocellular carcinoma and cholangiocarcinoma.
It is also performed for metastatic cancers, where cells from another body part, often colorectal cancer, have spread to the liver. Beyond malignant conditions, partial hepatectomy may be indicated for certain benign (non-cancerous) tumors, such as adenomas or large hemangiomas, especially if causing symptoms or complications. Severe localized liver injuries or specific liver diseases with irreparable damage may also necessitate surgical removal. The goal is to remove diseased tissue while preserving sufficient healthy liver for continued function.
The Surgical Procedure
Partial liver removal involves a planned surgical process, beginning with a thorough pre-operative assessment. Patients undergo extensive imaging (CT, MRI) to map liver anatomy, identify diseased tissue, and assess remaining healthy liver volume. Blood tests evaluate overall liver function and general health.
During the operation, patients receive general anesthesia. The surgeon makes an incision to access the liver, varying by surgical approach. Traditional open surgery involves a larger incision, typically below the ribcage or across the upper abdomen. Minimally invasive techniques, like laparoscopic or robotic-assisted surgery, use several smaller incisions for instruments and a camera.
Regardless of the approach, the surgeon dissects liver tissue, controlling blood vessels and bile ducts to minimize bleeding. Advanced devices, like ultrasonic energy or electrocautery, precisely cut the liver parenchyma. Once isolated, the diseased section is removed, sometimes through an enlarged incision if a minimally invasive approach was used. The surgical team works to ensure a clean margin around any tumors and confirms that enough healthy liver tissue remains for regeneration and proper function.
Recovery and Long-Term Outlook
Following partial liver removal, patients typically experience a hospital stay that can range from five to seven days, though it may extend up to two weeks depending on the complexity of the surgery and individual recovery. Immediate post-operative care focuses on managing pain, monitoring for potential complications like bleeding or infection, and ensuring adequate drainage from the surgical site. Patients are encouraged to move and gradually increase their activity levels to aid in recovery.
The remaining liver tissue begins to grow back to nearly its original size within approximately three months. This regeneration helps restore the liver’s full functional capacity, allowing most patients to return to normal daily activities. Long-term follow-up care involves regular appointments and imaging to monitor the liver and check for any recurrence, especially in cancer cases.
While most patients experience a good recovery with no long-term side effects directly from the surgery, lifestyle adjustments, such as a balanced diet and avoiding alcohol, might be recommended to support liver health. The success of the procedure, combined with the liver’s remarkable ability to regenerate, generally offers a favorable long-term prognosis for many individuals undergoing partial liver removal.