What should you know about total hepatectomy?

A hepatectomy is liver surgery. In everyday oncology discussions, the term often refers to removing part of the liver, also called liver resection. Removing the entire liver is different: the body cannot maintain normal filtering, metabolism, and bile production without functioning liver tissue. A transplant team must therefore assess whether transplantation is appropriate and available for the individual situation.

The reason for considering major liver surgery may include a primary liver tumour, cancer that has spread to the liver, or another complex condition. The tumour's location, number of affected areas, liver health, and overall fitness influence the surgical plan. Sometimes a smaller resection or tumour ablation is considered instead.

Ask the hepatobiliary surgeon to write down exactly what tissue may be removed and whether the plan is a partial resection, complete removal followed by transplant, or another approach. Bring a list of medicines, supplements, allergies, and previous operations. The team may arrange blood tests, imaging, anaesthetic review, and transplant assessment.

Plan practical support for hospital care and recovery. Discuss nutrition, wound care, activity limits, driving, work, and the medicines you may need after surgery or transplantation. Do not stop blood thinners or other prescribed medicines without instructions from the treating team.

After liver surgery or transplantation, contact the surgical team promptly for fever, worsening abdominal pain, repeated vomiting, increasing yellowing of the skin or eyes, confusion, unusual sleepiness, or a wound that becomes red, swollen, or increasingly painful. Seek emergency help for heavy bleeding, fainting, severe breathing difficulty, or sudden severe pain.

What exactly does total hepatectomy mean in my treatment plan? Why is it being considered, and could partial liver resection or tumour ablation be suitable? Would transplantation be required, and which assessments come first? What complications should my family watch for after discharge?