Hepatectomy (liver resection)

A liver resection, also referred to as a hepatectomy or hepatic resection, is a surgical procedure that involves removing part or all of the liver. It’s performed to treat liver diseases, including liver cancer, or when part of the liver is being donated for a liver transplant.

There are two main types of hepatectomy:

• Partial hepatectomy: Only a portion of the liver is taken out. This is commonly performed to remove tumors, cysts, or damaged sections of the liver while leaving healthy liver tissue intact. When only part of your liver is removed, the remaining section will regenerate itself, growing in proportion to your body size. 
• Total hepatectomy: The entire liver is removed. This procedure is typically done in preparation for a liver transplant, where the patient’s liver is replaced with a healthy donor liver.

At Penn Medicine, our liver resection surgeons are among the most experienced in the southeastern Pennsylvania and New Jersey regions. They work closely with our large team of liver specialists to provide expertise in liver resection and other liver surgeries needed to deliver great outcomes.

A hepatectomy is performed for several reasons, including:

• Liver cancer: The most common reason for a hepatectomy is to remove primary liver tumors or cancerous tissues that have spread to the liver from another part of the body, such as hepatocellular carcinoma, cholangiocarcinoma, or metastatic colon cancer.
• Liver cysts or abscesses: A hepatectomy is used to remove noncancerous growths or infected areas, such as gallstones, benign tumors, or liver cysts.
• Liver damage: A hepatectomy is performed to remove parts of the liver damaged by trauma or disease.
• Liver transplant: This procedure involves removing a portion of a living organ donor’s liver and transplanting it into the recipient. Both the donor’s and recipient’s livers will regenerate to their normal size within a few months.

A hepatectomy can be performed using open or laparoscopic surgery. Your surgeon will choose the most suitable method based on your specific condition. Laparoscopic surgery is less invasive, but open surgery might be required for more extensive or complex liver resections. Whenever possible, our surgeons use less invasive techniques, which use smaller incisions, are less painful, and result in faster recovery times.

Before your liver resection surgery, your doctor will explain the procedure and answer any questions you may have. Your care team will review your medications, discuss your health history, and provide detailed instructions on how to prepare for the surgery.

In situations where the liver resection is being done for liver cancer removal, treatments like radiation therapy, interventional radiology, or chemotherapy may be administered before surgery. These pre-operative treatments aim to shrink the cancer, making the surgery easier and safer, and enhancing the likelihood of curing the cancer successfully.

On the day of your hepatectomy, you can expect the following:

• You’ll receive IV anesthesia to ensure you’re asleep and pain-free during the procedure. 
• If you’re having open surgery, your surgeon will make one long incision and remove all or part of your liver. 
• If you’re having a laparoscopic liver resection, your surgeon will make several small incisions. Then they’ll use a small lighted camera and surgical tools to remove all or part of your liver. 
• Depending on the type of procedure and the extent of the resection, the surgery takes two to six hours. 
• After the surgery, our care team will closely monitor you as you wake up from anesthesia, and your doctor will prescribe pain medication to manage any discomfort.

Recovery from liver resection surgery varies from person to person. The average hospital stay is three to six days. By the time you leave the hospital, you should be able to perform most basic tasks. However, you should expect to be tired and arrange to rest at home for several weeks until your liver surgery recovery is complete.

You’ll meet with your surgeon to check on your recovery between one and two weeks after being discharged from the hospital. 

Penn Medicine surgeons specialize in hepatobiliary surgeries and have decades of experience treating the liver and nearby organs. This experience leads to the skill and knowledge to treat even the most advanced and rare liver diseases.

When you work with our liver experts, you can expect:

• Positive outcomes: Each year, our surgeons perform a high volume of liver surgeries, including more than 75 liver resections. Liver surgery is safer and has better outcomes when performed by experienced surgeons. 
• Advanced options for metastatic cancers: In the United States, most cancers spread to the liver from other areas of the body, such as the colon. Our patients have access to the most advanced therapies for these secondary liver cancers, including hepatic artery infusion (HAI) pumps. 
• Expertise in complex cases: Sometimes, you need more than one operation to treat liver cancer. During these multistage surgeries, we can take out part of the liver, let it regrow, and then remove more of the liver. These complicated procedures may involve close collaboration with interventional radiology. Our interventional radiologists are skilled in procedures that increase the size and strength of the healthy part of your liver, resulting in safer operations and better liver function. 
• Integrated care: Our hepatobiliary surgeons are just one part of a much larger team of gastrointestinal (GI) specialists. The whole team meets regularly to create individualized, effective treatment plans based on your needs. 
• Liver transplant program: Surgeons in our Penn Medicine Liver Transplant Program are among the most experienced in the greater Philadelphia, Lancaster, and Princeton regions. As a result, our patients have some of the best liver transplant outcomes in the country.