Hepatectomy (liver resection)

Hepatectomy is the removal of part of the liver. It ranges from a limited resection (a few centimetres) to removal of a whole lobe (right or left hepatectomy). It is possible because the remaining liver, if healthy, regenerates and recovers much of its volume within a few weeks. The operation is performed through an open incision under the ribs, or laparoscopically for well-placed resections. The surgeon may use ultrasound during surgery to locate the lesions and blood vessels precisely. The liver is divided while carefully controlling the blood vessels and bile ducts, to limit bleeding and bile leakage. The main indications are liver metastases (especially from colorectal cancer), hepatocellular carcinoma (primary liver cancer), some large or high-risk benign tumours, and certain forms of hydatid cyst. The volume and quality of the remaining liver are assessed before surgery; for a major resection, preparation (portal vein embolisation) may be offered. At Clinique Pasteur Tunis, the decision is made at a multidisciplinary team meeting, with CT and MRI available on site. The operation is performed with an anaesthesia team experienced in this surgery and intensive care available for monitoring during the first days.