Indications:
The reason for this operation is likely one or more growths, cancerous or non-cancerous, in your liver. Trauma to the liver is also a possible indication for this operation.
Procedure:
Your liver is the largest solid organ and sits on the right-hand side of your body just under your ribcage.
It has many vital functions, but you can live a normal life with only a part of your liver. A few weeks after your operation, the part of your liver that was not removed increases in size and takes over the function of the removed piece. Although the shape will be different, there will be no noticeable difference apart from your scar.
The part of your liver that gets removed or resected will depend on where the growth is in your liver. For example, if your growth is on the right side of the liver then you will have a right-sided liver resection, also known as a right hemi-hepatectomy. A growth on the left side would require a left-sided liver resection or left hemi-hepatectomy. A liver resection may be performed by open or minimally-invasive surgery.
A liver resection is a major operation and is only performed in specialised centres by qualified surgeons. This operation has potential complications. The potential complications and percentage risk are listed below:
- Chest infection in approximately 10%
- Wound infection in approximately 5%
- Bleeding and a return to theatre for an operation in approximately 1%
- Bile leak from the cut surface of the liver in approximately 10%
- Liver failure (remaining liver cannot cope) 5%
- Some people experience jaundice, (yellowing of their skin and whites of their eyes) as a result of the liver having to work harder and struggling to cope after partial removal. Jaundice under these circumstances is often temporary and disappears after a few days.
- The incision used for this operation is horizontal, following the natural shape and curve below your rib cage. Because nerve endings are cut during the operation, this may leave numbness around the scar site. People who experience this numbness report that it usually makes no difference to their quality of life.
- Unfortunately, there is a small percentage (about 2%) of patients who are at risk of dying from the operation.
The percentage risk of the complications and can change depending on the reason and size for your liver resection. Please discuss this in detail with your surgeon.
After your consultation:
- Obtain authorization from your medical aid and book your bed for your hospital admission.
- Carefully read through pre-operative information provided.
Day before surgery:
- Do not eat/drink after 22h00, the night before your surgery, unless otherwise specified by your surgeon or anaesthetist (you should be fasting for at least 6 hours before the procedure for solids but you are allowed to take clear liquids up to two hours before your procedure).
Day of surgery:
- Arrive for admission at indicated time on ‘Code & Consent’ sheet.
- Change into theatre attire, remove all valuable belongings.
The time the procedure takes varies but is in most cases between 4-8 hours in duration.
Duration of hospital stay:
- Usually 5 – 10 days (dependent on post-operative progress of patient)
Activities:
- Refrain from strenuous activities (incl. exercise) for at least 4 weeks post-operatively
Back to work:
- Sick leave required post-operatively is approximately 3 – 4 weeks in total
Some pain and discomfort post operatively may be expected following any operation, but the following measures are used to lessen the pain experienced:
- Warming devises in theatre as well as warm intravenous fluids.
- Intra-operative pain medication through the drip.
- Post-operative medication through the drip, please inform the nurses if you are in pain so that medication will be administered to you.
- As close to one week after discharge as possible. Please contact the rooms to schedule an appointment.
More procedures performed by Dr Jeske
A SKIN INCISION IS MADE AND THE CONTENTS OF THE ABSCESS IS DRAINED.
THE FISTULA TRACT IS IDENTIFIED AND IS OPENED ALONG ITS LENGTH, AND THE EXPOSED INSIDE OF THE TRACT IS THEN CLEANED OUT.
AN OPERATION TO REMOVE AN APPENDIX THAT IS INFLAMED/SWOLLEN/HAS RUPTURED/HAS FORMED AN ABSCESS.
THE COMMON BILE DUCT (CBD – THE MAIN TUBE CARRYING BILE FROM THE LIVER TO THE INTESTINE) IS OPENED UP. ANY GALLSTONES WITHIN THE DUCT CAUSING A BLOCKAGE CAN BE REMOVED.
PTC is a procedure performed by a radiologist (specialist X-ray doctor) who takes X-ray pictures of the bile ducts which are tubes inside the liver.
