Introduction
Liver resections are surgical procedures in which parts of the liver are removed. This is possible because the liver – unlike other organs – has the ability to regenerate itself to a certain extent. It is possible for the liver to regenerate up to 80% of its original size.
This means that the liver can regenerate after the operation, provided that not too much liver tissue has been removed. It is even possible to remove half of the liver, in this case it is called a hemihepatectomy. The entire liver can only be removed if a suitable liver transplant is available for the patient, because the liver is a vital metabolic organ of our body.
Liver resections are performed in different cases. Cancer of the liver and bile ducts or metastases in the liver from tumors of other organs may make resection necessary. Abscesses of the liver or cysts can also result in a liver resection if the findings are large. In addition, there is an infection caused by the tapeworm Echinococcus multilocularis, which may make a liver resection necessary.
Procedure of liver resection
Liver (partial) resection can be performed either by open surgery or minimally invasive laparoscopy. Both forms of surgery require an inpatient stay of several days to weeks and general anesthesia. In the open procedure, a larger abdominal incision is made to open the abdominal cavity.
In the minimally invasive procedure, surgical tools and camera are inserted through several small incisions. Before the actual resection, an ultrasound probe is often placed directly on the liver tissue and the entire organ is visualized once. In this way, further abnormalities can be detected that could not be seen in the previously performed imaging diagnostics.
If this examination does not reveal any reasons against the planned intervention, the liver part to be removed is freely prepared and displayed. It is particularly important to expose the blood vessels that will be supplied, which must be closed with a clip or sutures to prevent major bleeding. The part of the liver to be resected is then removed.
This can be done either with targeted electric shocks, a laser probe or conventional cutting tools. Afterwards, the resection area is usually sclerosed in order to prevent secondary bleeding and bile leakage. Before the operation is completed, the abdominal cavity is rinsed. Finally, the abdominal wall is closed again. Often, but not always, a scheduled monitoring stay in the intensive care unit takes place before the patient can be transferred to the normal ward for a few more days and then discharged.
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