Liver Resection – Decisions Before Surgery

Transcript

When we decide on a liver resection and a lesion must be removed, we can do wedge resection, which is just removing a little piece of the liver, or we can do a formal right or a left liver resection, removing like entire lobes of the liver. Because the liver is just one organ, but it has a right and a left lobe. And if we need extensive liver resection, we can even do what’s called a trisegmentectomy and remove almost two thirds of someone’s liver. What helps us determine how much liver we will remove is what the imaging show. How many liver lesions there are. And the quality of the liver background. Some liver lesions occur in the setting of a completely normal liver. And that gives us some opportunity to remove as much liver as we can. However, there are also some lesions of the liver that will occur in the setting of diseased liver, either a fatty liver or a diseased liver with cirrhosis. We can still operate on patients who have a background of liver disease, but we often have to try and remove as little liver as we can so that the patient doesn’t get acutely sick from liver resection. Regardless of what we do and how much liver we resect, once we’ve removed the liver and we thought there was good quality liver there, the liver regenerates itself back to its original size within about four to six weeks after surgery.