Liver resection

Learning objectives

Hepatectomy or liver resection is a surgical operation to remove part or all of the liver
Up to two-thirds can be removed as long as the rest of the liver is healthy
The liver can regenerate functionally active tissue after resection by hyperplasia of the remnant tissue
Liver is highly vascular and receives 25% of cardiac output, 80% is supplied by the portal vein and 20% by the hepatic artery
Is the treatment of choice for colorectal hepatic metastases without evidence of more distant disease spread
Also used in the management of benign and malignant primary hepato-biliary tumors, donation for transplantation, or hepatic trauma
The most common liver cancers treated by partial hepatectomy include:
- Hepatocellular carcinoma
- Cholangiocarcinoma
- Metastatic colorectal cancer
Other benign lesions include:
- Gallstones in the intrahepatic ducts
- Adenoma
- Liver cystadenoma or a cyst

Major liver resection	Right or left hepatectomy or lobectomy removes the right or left lobe
Minor liver resection	Segmental or wedge resection removes a segment or a part of a segment with a tumor with a margin around it Another minor liver resection is the left lateral sectionectomy, which removes the lateral part (section) of the left lobe
Multiple liver resections	Multiple tumors may be resected at the same time
Two-stage liver resection	If it is too dangerous to remove all the tumors at once