The surgical removal of all or part of the liver is known as liver surgery. It’s also known as a full or partial hepatectomy. When a damaged liver from a deceased donor is removed after a transplant, total liver surgery (resection) is performed.
The liver is a vital organ, meaning that one cannot live without it. The liver serves many critically important functions including metabolism of drugs and toxins, removing the degradation products of normal body metabolism (for example clearance of ammonia and bilirubin from the blood which are harmful to the body), and synthesis of many important proteins and enzymes (such as factors necessary for blood to clot & enzymes for digestion and fat metabolism).
The liver is located in the upper right-hand portion of the abdominal cavity, beneath the diaphragm, and top of the stomach, right kidney, and intestines.
Shaped like a cone, the liver is a dark reddish-brown organ that weighs around 1500 gms.
The liver mainly consists of 2 main lobes. Both are made up of 8 segments, which are further divided into 1000 lobules (small lobes). These lobules are connected to small tubes to the larger tubes which are eventually connected to the common hepatic duct.
The common hepatic duct transports the bile made by the liver cell to the gallbladder and duodenum via the common bile duct. The liver holds about 13% of the blood supply at any given moment.
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What is liver surgery?
Liver surgery is the surgical removal of a part of the liver. This operation is usually done to remove various types of liver tumors, benign as well as malignant ones, for treatment of stab wounds and other injuries to the liver.
The goal of this surgery is to completely remove the tumor and the appropriate surrounding liver tissue without leaving any tumor or diseased tissue behind.
This surgery gives the best chance of curing primary cancer. There are different types of surgery for treating diseases associated with the liver.
These are :
- Liver Resection or Removal of the part of the liver
- Liver transplant
The Benefits of Liver Surgery :
Removing a liver tumor that is cancerous is the surest method of:
- Eradicating the cancer
- Preventing its spread to another part of the body
- Curing your cancer or extending your life
Liver Resection :
Resection means the total or partial removal of the liver organ. The liver’s remarkable regenerative ability allows it to continue functioning, even when parts of it are removed.
Liver resection surgery is considered a high-risk procedure that should be performed by experienced surgeons. This surgery is safe when performed by skilled and experienced surgeons with appropriate technological and institutional support.
For people diagnosed with liver cancer, liver resection offers the best chance for cure or long-term survival.
To perform a liver resection surgery following points are kept in mind:
- The tumour must be confined to the liver and has not spread.
- The liver must have enough remaining healthy tissue for normal function after the diseased parts have been removed.
- People with underlying cirrhosis conditions may not tolerate as much of the liver being removed.
- Tumours that are located near some important blood vessels may require nonsurgical treatment methods, such as radiofrequency ablation (RFA).
Liver Transplant Surgery :
The doctor performs liver transplant surgery by removing your liver and replacing it with a donor’s liver.
A liver transplant is a surgery to remove your diseased or injured liver and replace it with a healthy liver from another person, which can be called the donor. If a liver stops working properly or fails to function, then a liver transplant can save the life. The Surgery can take up to 12 hours or longer.
Living with a Liver Transplant :
After the liver transplant, you will see your doctor often to make sure your new liver is working properly. You will have regular blood tests to check for signs of organ rejection and take medicine for the rest of your life to prevent organ rejection.
Liver Transplant recovery timeline :
A typical liver transplant recovery timeline includes –
- In one month: The staples are removed from the incision at the transplant centre.
- In one and a half months: the bile tube and the drainage tubes are removed during your clinic visit.
- In two months: A person can slowly start getting back to physical activity that is low intensity. He/she should absolutely avoid any sports or any physical activities that are high in intensity.
- In three months: You may begin your regular walking and jogging to some extent.
- In three to six months: Your liver incision has healed. You may resume and go back to work. A person should opt for a part-time job if he/she is still experiencing fatigue.
- In one year: A person now can start playing high-intensity sports and lifting weights. But a person should always ask and seek the permission of their surgeon and doctor before doing it.
Is Liver Surgery dangerous?
Like partial hepatectomy, a liver transplant is a major operation with serious risks and should only be done by skilled and experienced surgeons. After a liver transplant, regular blood tests are done to check for the signs of the body rejecting the new liver.
Sometimes liver biopsies are also taken to see if the rejection is happening and if changes are needed in the drugs that prevent rejection.
Possible risks include:
- Blood clots
- Complications from anaesthesia
- Rejection of new liver
What is the cost of a liver transplant in India?
The average liver transplant cost in India ranges from 10-20 lakh rupees, depending on the type of hospital you choose (private or government-run). Some private deluxe hospitals may charge up to Rs.35 lakhs for liver transplant surgery.
Other than the surgery, liver transplant patients are charged for medicine, supportive care post-transplant as well, so the actual cost of a liver transplant differs from the transplant package.
The actual cost of liver transplant surgery starts right from the initial tests, the transplant surgery to post-operative care and medications. This includes expenses done on:
- Laboratory tests
- Liver transplant surgeon’s fee
- Operation costs
- Hospital stays until recovery
- Stay and food for the family members during the course of surgery and hospitalization
- Anti-rejection drugs and other supportive medications
- Physical therapy
While planning your financial adjustments for a liver transplant, you should consider taking note of all these expenses well before in advance.
With the advances in medical and patient care, this surgery has evolved into a safe procedure with low mortality rates.
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Frequently asked questions about liver surgery:
Q. What is liver transplant surgery?
A. A liver transplant surgery is an operation that replaces a patient’s diseased liver with a whole or partial healthy liver from another person.
In most cases, the healthy liver will be received from an organ donor who has just died.
The liver is the only organ in the body that can replace it’s lost or injured tissue part (regenerate). The donor’s liver will soon grow back to normal size after the surgery. The part that you receive as a new liver will also grow to normal size in a few weeks.
Q. What is the survival rate of liver surgery?
A. Liver Transplant is very successful treatment and the in-hospital survival or success rate is more than 95% at advanced and well-equipped liver transplant centers. This means that out of 100 liver transplants performed, 95 patients recover and get discharged in a healthy state. 3-5% chances for risk of life is associated with this technically complex procedure.
Q. Is liver surgery a major surgery?
A. Liver resection is a major, serious operation that should only be done by skilled and experienced surgeons. Because people with liver cancer usually have other problems besides cancer, surgeons have to remove enough of the liver to try to get away all of the cancerous parts, but also have to take care to leave enough tissue of healthy liver behind for the liver to function.
Q. What are the types of liver surgery?
A. There are two types of liver surgery which are:
1) liver transplant – Your diseased liver is removed and replaced with a healthy liver from another person (a donor)
The most common reason for a liver transplant is if a person has a liver disease that is too advanced for other treatment.2) liver resection – The surgeon removes only a part of your liver where the tumor or cancer is operated on or removed.