Removal of part of the liver may be performed for tumours in the liver, tumours of the upper bile duct (hilar cholangiocarcinoma) and complex liver cysts (such as cystadenomas or hydatid cysts).

The liver is a large organ that sits in the upper right part of the abdomen, under the ribcage. The liver has many important functions including:

• breaking down and removing waste
• helping the blood to clot
• storing sugar
• making bile

The liver has two unique features that permit quite a large part of the liver (up to 75%) to be able to be removed without compromising its function.

• The liver has a very large reserve (there is more liver than is needed)
• The remaining part of the liver has the ability to grow (regenerate) after surgery

The amount of liver that can be safely removed depends on how healthy the liver is. Patients with fatty liver, liver affected by chemotherapy and chronic liver damage, especially cirrhosis, need a much larger amount of liver to get by.

In some cases, liver surgery can be performed laparoscopically (keyhole surgery), however many liver operations require an open operation (through a large single incision). The ability to perform the procedure laparoscopically depends on which part of the liver needs to be removed, the size of the tumour, the presence of adhesions from previous surgery and several other factors. The best approach for you will be discussed with you at your consultation.

Complications of liver surgery include:

• Bleeding
• Leak of bile from the cut liver surface
• Ascites (fluid development in the abdomen), jaundice, confusion and liver failure (where the remaining liver is not adequate)

Other risks include general risks of major surgery, such as blood clots in the legs (deep venous thrombosis) that can travel to the lungs (pulmonary embolism), infections and cardiac and respiratory problems.

With modern liver surgery, serious life-threatening complications are uncommon although the risk is higher in patients requiring major complex liver surgery. Your individual risk will be discussed with you prior to surgery. Most patients stay in hospital about a week after liver surgery although patients often go home earlier after laparoscopic liver surgery.