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CION Cancer Clinics
Segmentectomy, lobectomy and extended resection: the types of liver surgery | CION Cancer Clinics
Liver resections are named by how much liver is removed. A segmentectomy takes one small section, a lobectomy takes one whole side, and an extended resection takes more. The surgeon chooses the smallest operation that removes the whole tumour safely. This page explains each type, how the choice is made, and who cannot have a major resection. At CION Cancer Clinics, a multidisciplinary tumour board weighs your liver function and your scans before recommending any treatment.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed October 2026, next review due October 2027
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On this page
- What are the different types of liver resection?
- What does each operation actually remove?
- How does the surgeon decide which resection you need?
- What is the difference between a minor and a major resection?
- Who cannot have a major liver resection?
- What this page cannot tell you
- Common questions about types of liver resection
The short answer
What are the different types of liver resection?
Liver resections are named by how much liver is taken out. A segmentectomy removes one small section, a lobectomy or hemihepatectomy removes one whole side, and an extended resection removes one side plus part of the other.
The liver is divided by surgeons into eight segments. Each segment has its own blood supply and its own bile drainage, a little like flats in a building that each have their own water pipe. That is what lets a surgeon remove one part cleanly and leave the rest working.
The size of the operation follows the cancer and the liver
The surgeon plans the smallest operation that removes the whole tumour with a rim of healthy tissue around it. How big that has to be depends on where the tumour sits, how close it is to the main blood vessels, and how healthy the rest of the liver is. A bigger operation is not a better one. It is simply what the tumour's position demands.
This page covers both cancer that started in the liver and cancer that spread there. If yours spread from the bowel, the colon cancer pages cover your situation in more depth.From smallest to largest
What does each operation actually remove?
These are the names you are most likely to see on a consent form or a surgical plan.
Wedge or non-anatomical resection
A small piece of liver around the tumour is cut out without following segment boundaries. It suits small tumours near the surface and saves the most liver.
Segmentectomy
One or two whole segments are removed along their natural borders, together with their blood supply. This is often preferred for HCC, hepatocellular carcinoma, because the cancer can spread inside the segment's own vessels. More detail on the operation is on the segmentectomy and wedge resection page.
Lobectomy or hemihepatectomy
One whole side of the liver is removed. A right hepatectomy takes the larger right side. A left hepatectomy takes the smaller left side.
Usually chosen when
- The tumour is large
- Several tumours sit on one side
- The tumour lies near the main vessels of that side
Extended resection
One side plus extra segments from the other side. It leaves the least liver behind, so it is only possible when the remaining part is large and healthy enough.
Not sure whether this applies to you?
Ask an oncologistHow the plan is made
How does the surgeon decide which resection you need?
Mapping the tumour
A triple-phase CT or MRI shows exactly which segments the tumour touches and how close it lies to the main veins and bile ducts. CION arranges these scans through diagnostic partners.
Checking the rest of the liver
Blood tests such as bilirubin, the yellow pigment the liver clears, and albumin, a protein it makes, show how well the liver works. Signs of cirrhosis or raised pressure in the liver's veins also count.
Measuring what will be left
The surgeon estimates the future liver remnant, the part that stays behind. If it is too small, the liver may need to be grown first.
The tumour board agrees the plan
At CION, surgical, medical and radiation oncologists review the case together. They check whether surgery is the right choice at all, or whether ablation, TACE or medicines would serve you better.
Side by side
What is the difference between a minor and a major resection?
Minor resection
Major resection
Wedge, or one or two segments
Three or more segments, including a hemihepatectomy or an extended resection
Much of the liver is left behind
Far less liver is left, so its health matters more
Often possible with mild, well-working cirrhosis
Rarely safe in a cirrhotic liver
Often suits keyhole surgery
More often done as open surgery, though keyhole is used in some centres
Shorter hospital stay and quicker recovery
Longer stay, with closer watch for liver strain after surgery
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Not for everyone
Who cannot have a major liver resection?
A major resection does not suit most people with cirrhosis that is affecting how the liver works. Doctors grade this with the Child-Pugh score, a check of liver function from blood tests and symptoms. A liver that is already struggling may fail if a large part is taken away. The page on why surgery is often impossible in cirrhosis explains why a small tumour can still be unsafe to remove.
Other reasons surgery may not be offered
It is usually not offered when fluid has built up in the abdomen, called ascites, or when pressure in the liver's veins is high. It is also not offered when the cancer has spread outside the liver, or when the tumour has grown into the main vein on both sides. Serious heart or lung disease can rule it out too.
What may be offered instead
A smaller operation, ablation, TACE, radiation, a transplant assessment or medicines. A staged operation, where the liver is grown before the main surgery, is another route when only the size of the remnant stands in the way.
Being straight with you
What this page cannot tell you
It cannot tell you which operation you need. That comes from your own scans, your liver function and where your tumour sits in relation to the main vessels. Two people with tumours of the same size can need very different operations.
It cannot read your surgical plan for you
Plans often use segment numbers, such as "segments five and six", or terms like trisectionectomy. If you are unsure what is being removed, ask the surgeon to draw it on a picture of the liver. Good surgeons are glad to do this, and families often understand the plan better once they see it.
Who decides, and where it happens
CION's surgical oncologists assess and plan liver operations, and your team will tell you where the operation takes place. Scans, biopsy and any procedure to grow the liver beforehand are coordinated through accredited partner hospitals.
If one surgeon has said "too risky" and another has said "possible", the tumour board can review both opinions.Questions we are asked
Common questions about types of liver resection
Is a lobectomy the same as a hepatectomy?
Hepatectomy means any removal of liver. A lobectomy, also called a hemihepatectomy, removes one whole side. So every lobectomy is a hepatectomy, but a hepatectomy can also be much smaller, such as a single segment. Ask which one your plan means.
Does a bigger operation mean the cancer is worse?
Not always. A small tumour sitting next to a main blood vessel can need a larger operation than a bigger tumour near the edge of the liver. The size of the operation reflects the tumour's position as much as its size.
How much of the liver can be removed?
In a healthy liver, a surprisingly large share can be removed, and the rest regrows. In a liver with cirrhosis or damage from chemotherapy, much less can be taken safely. Your surgeon measures the part that will be left before deciding.
Will my liver grow back after the operation?
A healthy liver regrows to close to its original size over the following months. It grows back in bulk rather than reshaping the removed part. A cirrhotic liver regrows less well, which is one reason surgery is planned more carefully in cirrhosis.
Can these operations be done by keyhole surgery?
Many smaller resections can be done by keyhole surgery, and some larger ones too, depending on the tumour and the surgeon. Open surgery is sometimes the safer choice. The page on laparoscopic and robotic liver surgery explains how that choice is made.
Why remove a whole segment instead of just the tumour?
For HCC, cancer cells can travel inside the small vessels of the same segment. Removing the whole segment takes those vessels too. For some other tumours, a smaller cut that saves more liver is preferred. Your surgeon will explain which applies.
What is a trisectionectomy?
It is an extended resection. One whole side of the liver is removed along with a further section from the other side, leaving only a small part behind. It is only possible when that remaining part is healthy and large enough, sometimes after growing it first.
How do I get my surgical plan reviewed?
Gather your scans on disc, the scan reports and any blood results. Call the CION helpline and the team will explain how the tumour board can review them. A second look is reasonable before any major liver operation.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- American Cancer Society — Surgery for Liver Cancer
- Cancer Research UK — Surgery for liver cancer
- MDCalc — Child-Pugh Score for Cirrhosis Mortality Calculator
- National Cancer Institute — Surgery for Cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Anatomical vs Non-Anatomical ResectionWhy some surgeons follow segment borders and some do notHow Much Liver Can Be Safely Removed?The limit that sets the size of the operationLaparoscopic and Robotic Liver SurgeryWhich of these operations can be done by keyholeMajor vs Minor Liver Resection: The DifferenceThe operative detail behind each type
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Not sure what your surgical plan means?
Bring your scans and the plan you were given, and our team will explain it in plain words or arrange a tumour board review. One helpline serves every CION centre.