Medical Oncologist
CION Cancer Clinics
Liver resection: what the operation involves, stage by stage | CION Cancer Clinics
In a liver resection, the surgeon removes the part of your liver that holds a tumour and leaves enough healthy liver behind to keep you well. It is done under general anaesthetic, through one cut under the ribs or several keyhole cuts. Afterwards you spend a short time in a closely watched unit, then on the ward. This page walks through each stage, and says what it cannot tell you. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- What actually happens during a liver resection?
- What happens between the first scan and going home?
- Which kind of liver resection might you be offered?
- What do the words on your consent form mean?
- Who is it not suitable for, and what can this page not tell you?
- What do families worry about, and what is actually true?
- Common questions about liver resection surgery
The short answer
What actually happens during a liver resection?
The surgeon removes the part of your liver that holds the tumour, with a rim of healthy tissue around it. The rest of the liver stays in place and keeps doing its work while it slowly grows back in size.
Why the liver can be operated on at all
The liver is divided inside into sections, each with its own blood supply and its own bile drain. That lets a surgeon take away one section, or several, without cutting off the parts that stay. The operation is planned around those sections, not simply around the lump.
The real question is what is left behind
How much is removed matters less than how much healthy liver remains. Before the operation, your team measures the part that will be left on a scan and checks how well it works on blood tests. If that part looks too small or too damaged, the plan changes before anyone goes to theatre.
Who is involved
A liver surgeon leads, but an anaesthetist, a radiologist who reads the scans, and a medical oncologist usually shape the plan together. Many people have chemotherapy before or after the operation, depending on the type of cancer.
Liver resection is used for cancers that start in the liver and for cancers that have spread there, most often from the bowel. The pathway differs a little between the two.Stage by stage
What happens between the first scan and going home?
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Tests and planning
Expect a detailed CT or MRI scan, blood tests of liver function, and checks on your heart and lungs. Your case is discussed at a tumour board before a date is set.
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The anaesthetic
You are fully asleep. The anaesthetist may also place a thin tube in your back or beside the wound to control pain for the first few days.
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Finding the tumour inside
Through one cut under the ribs, or several small keyhole cuts, the surgeon runs an ultrasound probe over the liver itself. This maps the tumour and the blood vessels and sometimes finds spots the scan missed.
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Dividing the liver
The liver tissue is separated with instruments that seal small vessels and bile ducts as they go. The blood flow into the liver may be clamped for short spells to limit bleeding.
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A closely watched unit
Most people spend the first night or two in intensive care or a high dependency unit, with drips, a urine tube and often a drain.
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The ward and home
You are helped out of bed early and started back on fluids and food as soon as it is safe. You go home once you are eating, walking and your blood tests are settling.
Not sure whether this applies to you?
Ask an oncologistTypes of operation
Which kind of liver resection might you be offered?
The names describe how much is taken and how. Your surgeon picks one on the basis of where the tumour sits and how healthy the rest of the liver is.
Wedge resection
A small piece of liver around a tumour near the surface is removed, without following the internal sections. It spares the most liver.
Segmentectomy
One or more of the liver's internal sections is removed along its natural boundaries, with its own blood supply and bile drain.
Major hepatectomy
Most of the right or left side of the liver is removed. This is a bigger operation with a longer recovery, and the remaining liver has more work to do at first.
Usually needed when
- The tumour is large
- It sits close to the main vessels
Keyhole or robot-assisted
Any of these can sometimes be done through small cuts with a camera. Whether it suits you depends on the tumour's position and your centre's experience, so ask how often they do it.
!
After you go home, do not wait on these
Call your surgical team or go to the nearest emergency department the same day if there is a fever or shivering, yellowing of the skin or eyes, tummy pain or swelling that is getting worse, breathlessness, confusion or unusual sleepiness, or fluid leaking from the wound. These can be signs of infection, a bile leak or the liver struggling. Do not take pain medicines from the chemist to settle it first.
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On your paperwork
What do the words on your consent form mean?
- Hepatectomy
- Removal of part of the liver. A right or left hepatectomy removes most of that side.
- Segment
- One of the liver's internal sections, each with its own blood supply. Your report may name them by number.
- Margin
- The rim of healthy tissue around what was removed. A clear margin means no cancer cells were seen at the cut edge.
- Future liver remnant
- The part of the liver that will be left behind. Your team measures it before deciding the operation is safe.
- Bile leak
- Bile seeping from the cut surface of the liver. It is usually picked up in the drain and often settles on its own.
Being straight with you
Who is it not suitable for, and what can this page not tell you?
Liver resection is not the right step for everyone with a liver tumour. Your team weighs several things, and the answer can change as tests come back.
When it is often not offered
It is usually not suitable when the cancer is spread widely through both sides of the liver, when there is cancer elsewhere that surgery cannot deal with, or when the liver is badly scarred by cirrhosis. It may also be unsafe if your heart or lungs would not cope with a long anaesthetic. In those cases other treatments, such as ablation, radiotherapy or medicines, are discussed instead.
What this page cannot tell you
It cannot tell you whether you should have the operation. That is a decision for you and your treating team, made with your scans in front of them. It also cannot tell you how your recovery will go, because that depends on the size of the operation, your liver's health and your fitness beforehand.
Questions worth asking your surgeon
Ask which part of the liver will be removed, how much will be left, what the other options were, and how often the team does this operation.
Commonly believed
What do families worry about, and what is actually true?
"Once the tumour is exposed to air, the cancer spreads."
Cancer does not spread because air reaches it during surgery. This belief makes people delay an operation that may be the most useful step they have. What the surgeon sees inside simply confirms what the scans already suggested.
"You cannot live with part of your liver missing."
You can, provided enough healthy liver is left. The part that stays takes on the work and grows in size over the following weeks and months. This is exactly what the planning scans are checking.
"Keyhole surgery is always the safer choice."
Small cuts can mean a quicker recovery for the right tumour. For a large tumour or one near major vessels, an open operation may be the safer route. The choice follows the tumour, not the size of the scar.
"If the operation goes well, nothing more is needed."
Many people still need chemotherapy and regular scans afterwards, because the pathology report may change the plan. Follow-up is part of the treatment, not an optional extra.
Questions we are asked
Common questions about liver resection surgery
How long does the operation take?
Usually several hours, and longer for a major hepatectomy or a keyhole operation. The time includes the anaesthetic, the ultrasound check inside and careful closing. Families are often worried when it runs long. A long operation is not in itself a sign that something has gone wrong, and the team will update you afterwards.
Will I have a big scar?
An open operation leaves a scar under the ribs, sometimes curving towards the middle of the tummy. A keyhole operation leaves several small scars and one slightly longer cut to take the liver piece out. Scars fade over the following months, but they do not disappear completely.
How much pain should I expect?
There will be pain, and it is controlled with a plan rather than left to chance. An epidural or a small tube beside the wound is common in the first days, then tablets. Tell the nurses early if pain stops you coughing or walking, because both matter for your recovery.
How long will I stay in hospital?
It varies with the size of the operation. Smaller and keyhole resections usually mean a shorter stay. A major hepatectomy usually means a longer one. You go home when you are eating, walking, passing urine normally and your liver blood tests are moving in the right direction.
Will I need a blood transfusion?
Many people do not. The liver has a rich blood supply, so blood is cross-matched and kept ready before the operation. The anaesthetist and surgeon use several methods to limit bleeding. If you have concerns about receiving blood, raise them at the pre-operative visit, not on the morning of surgery.
Should I stop my medicines before surgery?
Do not stop, start or change any medicine on your own. Blood thinners such as aspirin or clopidogrel, diabetes medicines and some herbal remedies may need a plan. Your surgeon, anaesthetist and the doctor who prescribed them will tell you exactly what to do and when.
When can I eat normally again?
Most people start sips of fluid soon after the operation and move to light food over the next few days. Appetite is often poor at first and returns slowly. Small, frequent meals with enough protein help the liver regrow. Avoid alcohol entirely until your surgeon says otherwise.
Is it covered by Aarogyasri or my insurance?
Cancer surgery is often covered when it is part of an approved treatment plan. Aarogyasri, CGHS, ECHS and EHS are accepted, and most cashless insurers are empanelled. Call the helpline with your card details and scheme papers, and the team will check your specific cover before admission.
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MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
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Dr. Vinay Mamidala
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Dr. Vajja Sandeep Kumar
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Sources
- NHS — Liver cancer: treatment
- American Cancer Society — Surgery for liver cancer
- National Cancer Institute — Adult primary liver cancer treatment (PDQ), patient version
- Cancer Research UK — Liver 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
How Much Liver Can Be Safely Removed?What decides whether the part left behind is enoughMajor vs Minor HepatectomyHow the size of the operation changes recoveryRecovery Timeline After Liver ResectionWhat the weeks after going home usually look likeComplications and Red FlagsEvery same-day warning sign after cancer surgeryLiver Resection (Hepatectomy)The main guide this page belongs to
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