Ben Cresswell - Expert, Personalised Surgical Care | Gallstone and gallbladder surgery in Basingstoke Hampshire | Liver cancer surgery in Basingstoke and Hampshire | Hernia surgery in Basingstoke and Hampshire

The liver is the largest solid organ in the body, located beneath the ribs on the right-hand side. It plays a vital role in:

• Producing proteins needed for blood clotting and nutrition
• Storing and releasing energy
• Processing and removing toxins
• Producing bile, which helps digest fats and absorb vitamins

The liver has a remarkable ability to regenerate, meaning that if a portion is removed, the remaining part can grow to compensate in size over time – this normally takes around 4 months.

Before recommending liver surgery, two key factors are assessed:

1. Fitness for surgery – general health, heart and lung function, and recovery potential
2. Liver remnant volume – ensuring enough healthy liver remains after surgery to allow recovery and regrowth

My surgical philosophy is to remove only what is necessary to clear the cancer while preserving as much healthy liver as possible — an approach known as parenchymal-sparing liver resection. This technique helps:

• Reduce surgical risk
• Preserve liver function
• Allow more treatment options in the future, if needed

In complex cases, additional techniques can be used to make surgery possible or safer, including:

• Ablation (destroying smaller tumours using heat)
• Preoperative portal vein embolisation (to stimulate growth of the remaining liver)
• Staged liver resection (performing surgery in two stages to allow regrowth between operations)

Every patient undergoes detailed imaging and multidisciplinary review before surgery.

You will usually need:

• CT scan of the chest, abdomen, and pelvis (to check for cancer spread)
• MRI of the liver (to plan the operation)
• Sometimes a PET-CT scan (for certain cancers)

All scans should be recent (within 6–8 weeks of surgery).

Your case will be discussed in a specialist multidisciplinary team (MDT) meeting, where surgeons, oncologists, and radiologists collaborate to plan the best approach.

Other important preparation steps:

• Stop chemotherapy for at least 6–8 weeks before surgery – chemotherapy works by targeting rapidly dividing cancer cells and following a major operation, we need normal healthy cells to rapidly divide to allow healing and prevent complications
• Stop or reduce smoking and alcohol to aid recovery
• Maintain a healthy diet and gentle exercise routine

Liver surgery is carried out under a general anaesthetic and may be done as a keyhole (laparoscopic) or open procedure. The choice of keyhole or open surgery is determined by the type and location of the cancer, the planned complexity of the operation, any previous surgery and patient preference.

Keyhole (laparoscopic) surgery:

• Small incisions and minimal scarring
• Usually 24–36 hours in hospital
• Recovery at home: 2–3 weeks

Open surgery:

• Incision under the right rib cage
• Hospital stay: 3–4 days
• Recovery at home: 4–6 weeks

Most patients can eat and drink soon after surgery, and you should expect to be getting out of bed from the first day to speed recovery.

Pain is managed with small local anaesthetic catheters and oral medication from day one following open liver surgery.

All operations carry risks, but serious complications are uncommon.

Possible risks include:

• Bleeding: rare (<2% require transfusion)
• Bile leak: occurs in <3% of cases, often settles on its own
• Infection: this can occur at the operation site, the wound or in the chest, it usually responds to antibiotics
• Liver insufficiency: this is a condition where insufficient liver has been left behind to support normal function. It can range in severity from causing some jaundice and swelling to being more serious, leading to kidney damage and be potentially life threatening. The risk is related to the size of the operation and the quality of the background liver tissue

With modern techniques, the risk of death from surgery or a complication is under 1%.

In my own practice, I have never had to reoperate for bleeding and maintain complication rates well below national averages.

The outcomes of liver resection depend on the type and stage of cancer, but for many patients, even those with Stage 4 (metastatic) disease, liver surgery can offer a real chance of long-term survival or cure.

Your individual prognosis and treatment plan will be discussed fully at your consultation.