Surgery for secondary liver cancer

Liver resection Back to top

It may be possible to remove the affected part of the liver with surgery. This sort of surgery is called a liver resection and is most commonly used to remove secondary liver tumours that have come from a primary cancer in the bowel. If the cancer cells are in a single area of the liver, and there is no cancer anywhere else in the body, the surgery may sometimes cure the cancer.

Recent improvements in liver surgery mean that several tumours can sometimes be removed from more than one area of the liver in a single operation. However, it is hardly ever possible to carry out a liver resection if there are also cancer cells in another part of the body.

Liver resection is a major operation that takes from 3–7 hours, and is carried out in specialist liver surgery hospitals. It is only suitable for some people with secondary liver cancer. There are usually no long-term side effects following liver resection, as the remaining liver can regrow within a few months of the operation and carry out all its normal functions.

You can discuss with your doctor whether surgery may be helpful in your particular situation.

Liver transplants (removal and replacement of the liver) are not used for people who have secondary liver cancer. This is because the cancer usually comes back soon afterwards due to the drugs that are used to prevent the body rejecting the transplanted liver.

Chemotherapy| may be used to shrink tumours before surgery to make the operation safer and more successful. Or it may be used after surgery to reduce the risk of the cancer coming back.

Before any operation, make sure you have discussed it fully with your doctor so that you understand what it involves. Remember, no operation or procedure will be done without your consent|.

Portal Vein Embolisation (PVE) Back to top

The liver can rebuild itself very quickly. When removing part of the liver the doctors need to know that there will be enough left for it to be able to function afterwards. It is sometimes possible to encourage the liver to enlarge before an operation is done.

Portal Vein Embolisation involves putting a tube into a vein in the part of the liver to be removed and blocking the blood supply to that area. This encourages the healthy part of the liver to grow. This way, the doctors know that there will be enough liver to function once they have removed the affected part.

Staged liver resection Back to top

This is where as much liver is removed as possible with the first operation, and then another resection is done a few weeks after the first one, when the liver has had a chance to grow back.

After your operation Back to top

After your operation you may be taken to the intensive care ward or high-dependency unit for about 24 hours. This is because the liver has a very good blood supply and there is a risk that it may bleed after surgery. The doctors and nurses will keep a very close check on your blood pressure.

You will have a dressing over the operation site on your abdomen, and if necessary one or more drainage tubes will drain fluid and blood from the wound site into drainage bags. The nurses will regularly measure the amount of blood (if any) in these bags. When the drainage has almost stopped, the tube(s) will be removed. This usually takes place after a few days.

Drips and drains

You will also have a drip (intravenous infusion) going into a vein in your arm to give you fluids and essential nutrients. This will be removed once you are eating and drinking properly again – usually within a few days.

A small tube called a catheter will be put into your bladder to drain your urine into a collecting bag. This will save you having to get up to pass urine. It is usually removed after a few days.

Pain

It is normal to have some pain| or discomfort after an operation on the liver. You will be given regular injections of painkillers for several days after the operation to prevent and relieve pain. You may also be given injections of anti-sickness drugs (anti-emetics|).

Going home

Most people are able to go home 10−14 days after their operation. They will probably need painkillers for the next few weeks. It may take up to six weeks before people start to get back to normal.