Life Expectancy After Liver Resection

The liver is one of the most essential organs of the body. It is found above the stomach and below the diaphragm on the right side of your abdomen. Its roles include blood volume regulation, immune system support, macronutrient metabolism, and lipid and cholesterol homeostasis. It also produces a fluid substance called bile, which is responsible for breaking down fats so they can be absorbed by the digestive tract. 

What is liver resection (hepatectomy)?

Liver resection is a surgical operation to remove part of your liver. The remaining part of your liver will then grow to replace the removed part.

The surgery itself should take several hours, depending on the complexity. Before the surgery, you will be required to undergo preoperative evaluation and may have to undergo adjunct operations such as preoperative portal vein embolization (PVE) to ensure your liver has enough capability to generate back sufficiently. 

You may be advised not to eat or drink anything on the day of the surgery. In the hospital, you will be placed under general anesthetic for the procedure. 

Generally, you can expect to stay in the hospital for up to a week after the surgery. This means that doctors can keep an eye on your recovery process, manage pain, and ensure that no unwanted side effects are occurring. You won’t be able to go straight back to eating solid foods. You will have to start slowly with consuming liquid food. 

Moving around as much as you can is important following surgery, as this will reduce the risk of blood clots forming and speed up the recovery process. Once you’ve been sent back home, you can expect to have follow-up appointments at the hospital to ensure your recovery is progressing well. 

Why is liver resection performed?

Liver cancer is the fifth most common cancer in the world and the second highest cause of cancer deaths. There are around 500,000–1,000,000,000 new cases annually.¹ ²

However, it is rare in Western countries, including the US, due to regulations on environmental toxins as well as vaccination against and exposure to hepatitis viruses, with an average of only 6.7 cases per 100,000 compared with 93.7 per 100,000 in Mongolia. 

Liver cancer is the main reason for performing a liver resection, to remove the part of the liver where the cancer is growing.

Causes of liver disease that may require hepatectomy

Usually, a hepatectomy is done for the treatment of liver cancer. However, benign conditions may also necessitate resection as well as hemorrhage associated with trauma.

Gallstones, crystalline masses formed from bile pigments, cholesterol, or calcium, can extremely rarely form within the liver instead of their typical location, the gallbladder, termed primary intrahepatic lithiasis (PIL). In such cases, liver resection can be a treatment of choice, though they can also be managed conservatively, depending on the severity. 

​​Echinococcosis (hydatid disease) caused by a tapeworm can cause cysts on your liver. Although there are numerous treatment options, hepatic resection can be a radical treatment option as well.

Liver resection may also be used for the treatment of hemangiomas, simple cysts, focal nodular hyperplasia, bacterial hepatic abscesses, amebic liver abscesses, and major hepatic trauma.

Types of liver resection

An anatomic resection involves the removal of a tumor and the veins draining that particular area. A nonanatomic resection involves removal that does not perfectly match anatomically with the Couinaud segments and may be needed if anatomic resection would result in inadequate residual liver volume to support recovery, such as in patients with cirrhosis.³

The type of resection depends upon the location of the lesion(s), the capability of the hepatic remnant to regenerate, and a tumor-negative margin if appropriate. Types of resection include segmental resection (sectionectomy vs. sectorectomy), hepatectomy (left or right), extended hepatectomy (left or right), as well as wedge resection, which is nonanatomic.

Life expectancy after liver resection

Five-year survival rates following liver resection are around 50–70% for those with HCC without cirrhosis. Comparatively, perioperative mortality is about 1–3% in high volume centers. Both morbidity and mortality rates are improving thanks to advances in medicine.⁴ ⁵ ⁶

Life after liver resection surgery

Although highly personalized, for minor or uncomplicated major hepatic resections, you may be discharged in four to six days to recuperate at home for a couple of weeks. You could need around six to eight weeks to recover before you can resume your regular activities. 

Quality of operative methods and post-operative care have improved over time with more individualized care, boosting your quality of life following surgery. Unfortunately, complications can occur in up to 40% of patients without cirrhosis and major complications in 10–20%.

Speeding up liver resection recovery

Gentle walking daily following a liver resection is a great way to speed up recovery. Drink plenty of fluids and eat regular, healthy meals. Avoid strenuous activities like running, biking, and heavy lifting. It may be best to check with your doctor, but avoiding or limiting alcohol will help your liver take the time to recover. 

Difference between laparoscopic/robotic and open hepatectomy

In a laparoscopic (keyhole) hepatectomy, the operation occurs through a small keyhole while your surgeon looks at images through a screen. Generally, this procedure is used for less complex liver resections.

Open surgery is generally used for more complex procedures. In this, your abdomen is opened via one long incision, allowing surgeons to visualize your abdomen directly. 

What happens when you have part of your liver removed?

The liver has a unique ability to regenerate itself following damage. Following surgery, the remaining healthy cells of the liver will then be able to partially or fully regenerate the area lost in surgery.  

The lowdown

Liver resection may be required for liver cancer or other diseases of the liver. This operation will vary depending on how much of the liver needs to be removed. After surgery, the liver is able to regenerate its own tissue, and you can expect to have a relatively good quality of life following surgery. 

Improvements in medicine and healthcare now mean that your chances of survival and recovery without complications are improving, so you can have more time living a strong and healthy life. 

Talk to your doctor if you have any concerns about a liver resection and how to improve your chances of recovery and take care of your overall health. 

Frequently asked questions

Is liver resection major surgery?

Liver resection is a major and serious operation. Liver resection is considered a relatively complex operation because of the many vessels in the liver, increasing the possibility of bleeding and making some tumors difficult to access and remove. 

Can HCC come back after liver resection?

This is a highly individualized question. However, long-term relapse-free survival rates can average 40% or better, and five-year survival rates can be as high as 90% in highly select patients, such as those with smaller and local tumors that are deemed possibly curable with hepatectomy.

Which liver surgery complication is most fatal?

Wound infection was the most common complication identified in one study. However, at around 8%, this was still relatively uncommon. Post-hepatectomy liver failure (PHLF) is the most serious complication following hepatic resection, and it can be fatal in up to 70% of cases.⁷ ⁸