Surgery for secondary cancer in the liver

It may be possible to remove the affected part or parts of the liver with surgery (a liver resection). Liver resection is a major operation that takes 3–4 hours. There are usually no long-term side effects. Liver resection is most commonly used to remove secondary liver tumours that have come from a primary cancer in the bowel, but occasionally it is used for other primary cancers.

Before the operation, it is sometimes possible to encourage the healthy part of the liver to grow. This helps to make sure there is enough liver left afterwards and reduces the risk of liver failure. It is done by blocking a branch of the main vein leading to the liver (the portal vein) and is called portal vein embolisation (PVE).

Sometimes, the liver is removed in two stages (staged liver resection). Part of the liver is removed in the first operation, and then another resection is removed a week or more after the first one.

It may be possible to have keyhole (laparoscopic) surgery to remove the affected part of the liver. This leaves much smaller wounds, so you have less pain after the operation and a quicker recovery.

About surgery for secondary cancer in the liver

It may be possible to remove the affected part or parts of the liver with surgery (a liver resection). This operation is most commonly used to remove secondary liver tumours that have come from a primary cancer in the bowel. Occasionally it is used for other primary cancers.

Liver resection is a major operation that takes 3–4 hours. It is carried out in specialist hospitals by doctors called hepatobiliary surgeons, who are experienced in liver surgery. It is only suitable for some people with secondary liver cancer. There are usually no long-term side effects following a liver resection. This is because the remaining liver can regrow within a few months of the operation and carry out all its normal functions.

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

You can discuss with your doctor whether surgery may be helpful for you.


Portal vein embolisation (PVE)

Before removing part of the liver, it is sometimes possible to encourage the healthy part of the liver to grow. This helps to make sure there is enough liver left after the operation and reduces the risk of liver failure. It is done by blocking a branch of the main vein leading to the liver (the portal vein) and is called portal vein embolisation (PVE).

PVE is usually done in the x-ray department. You will have a local anaesthetic to numb an area on your tummy (abdomen). Using ultrasound for guidance, your doctor will then make a small cut in your skin. A fine tube (catheter) is then gently pushed into the cut and guided into the portal vein. Once the catheter is in the right place in the liver, special glue and/or very small metal coils will be injected to block off the area.

PVE usually takes between 90 minutes and 2 hours. You may feel some gentle pushing as the catheter is inserted. Tell your doctor if you feel any pain or discomfort. They can give you painkillers. You will usually have to stay in hospital overnight for this treatment.


Staged liver resection

This is where the liver is removed (resected) in two stages. Usually, part of the liver is removed in the first operation, and then another resection is then done a week or more after the first one, when the liver has had a chance to grow back.


Keyhole (laparoscopic) surgery

In some situations, it may be possible to have keyhole (laparoscopic) surgery to remove the affected part of the liver. Several small cuts (incisions) are made instead of one large cut. Generally about three small cuts and one larger cut are needed.

The surgeon uses a laparoscope to see inside your tummy.

This is a thin tube with an eyepiece at one end, and a light and a magnifying lens at the other. It is put into your abdomen through a small cut in the skin. The larger cut is usually made close to your belly button and is used to remove the affected part of the liver.

The main advantage of this type of surgery is that it leaves much smaller wounds, so you have less pain after the operation and a quicker recovery.

Keyhole surgery should only be carried out by surgeons with specialist training and experience in using laparoscopic techniques. So if it’s suitable for you and you choose to have this type of surgery, you may need to travel to another hospital to have it.

Back to Surgery explained

Who might I meet?

A team of specialists will plan your surgery. This will include a surgeon who specialises in your type of cancer.

What happens after surgery?

You’ll be monitored very closely after your operation. You will be very tired so it’s important to rest and look after yourself.