Liver Surgery& Associated Treatments
This is an overview of various liver treatment techniques and procedures. If you need more information or have a question about these surgical procedures or treatments, don’t hesitate to contact our friendly team to make an enquiry. We are here to help and to provide information, comfort and quality care.
A hepatectomy procedure involves removing part of the liver. The liver has quite a complex internal anatomy and consists of 8 segments. The blood vessels that enter the liver divide in left and right branches and therefore the liver has a left and a right side referred to as right or left hemi-liver. Further divisions define the segments of the liver. At The Liver Centre WA one of our priorities is to help you understand the complexities of the human body, specific conditions and the steps involved in your surgery.
Liver resection surgery involves removing one or several of these liver segments. The image below shows some of the classic liver resection procedures in more detail.
As we discuss the recommended type of liver treatment to suit your needs, we will discuss the segments of your liver that may need to be removed. Some small lesions only require the removal of one liver segment, and this is called a segmentectomy. If the lesions are small and only superficial, a very local resection can be recommended (a subsegmental liver resection). This type of small liver surgery can be done laparoscopically.
In case of a bile duct cancer, your surgeon may recommend a combination: a liver resection, and a reconstruction of the biliary drainage using a loop of intestine. This is an extremely complex surgery.
Whatever the complexity level of your surgery, you deserve expert surgery and quality care and support. At The Liver Centre WA that’s our commitment: to offer you the experience we have gathered safely performing hundreds of liver surgeries for our Perth patients at The Liver Centre WA. The quality of surgery developed at The Liver Centre WA is unique and extremely safe, because we use our experience in liver transplantation as well as the same advanced surgical techniques.
This level of expertise also helps when a patient has been diagnosed with metastases in the liver. Cancers that cause secondary lesions in the liver are cancers of the colon and rectum, skin and eye, and breast. A metastasis is a migrated cancer, that originated in other areas of the body.
At The Liver Centre WA in Perth, our liver surgeons have performed hundreds of liver surgeries and transplants. We also focus on your experience as a patient, with genuine support as you prepare for surgery. Our team of dietitians and specialist doctors is here to help you recover in the most effective and comfortable way.
In some circumstances your hepatologist or liver surgeon at The Liver Centre WA may have to tell you that liver transplantation is the best option for your treatment. Part of your assessment can be organised in private practice but most of it would be done in the WA Liver Transplant Service at Sir Charles Gairdner Hospital. Prof Delrivière, Prof Jeffrey and Dr Michael Wallace work in that service. It is important to mention that liver transplantations are only performed in the public services and for Australian Medicare entitled patients. We do not perform live liver donation for adult to adult or adult to child liver transplantations in Western Australia.
A liver biopsy may be performed prior to your liver surgery, so your surgeon can get a clear idea on the state of your liver and a detailed diagnosis of its condition. This procedure is performed under local anaesthesia or light sedation by a specialist radiologist using an ultrasound.
This information is important to define how much of the liver can be removed safely.
As a team of liver specialists and liver surgeons, we always commit to working out the safest, most comfortable and most effective surgery type for you. Our commitment is to work towards excellence in surgical outcomes. And we also work together as a team to make sure you have a clear understanding of the test results, your diagnosis, and the recommended treatment options we put forward. What our patients appreciate about working with The Liver Centre WA, is our focus on genuine patient care and support before, during and after your surgery.
Microwave ablation for liver tumours
Microwave ablation is a technique which is sometimes used during a liver surgery. The technique burns liver lesions using microwave technology. In some cases, if lesions have been diagnosed on both sides of the liver, the hemi liver that contains multiple lesions will be removed, and the lesions on the other side will be burnt using microwave ablation.
Techniques to expand the left side of the liver
In certain cases, major liver resection would leave less than 25% of the liver volume, which is a dangerous situation. In this situation your surgeon will recommend the use of one of 2 techniques to expand the remaining side of the liver:
SIRT or Selective Internal Radiation Therapy is also known as Radio-embolisation. Your liver surgeon may recommend it in case of advanced liver tumours, prior to the actual liver surgery. The technique is applied by an interventional radiologist, injecting radioactive beads via the hepatic artery. The injection of the beads targets the tumours. This technique is sometimes used to control inoperable tumours.
The radioactive beads locked in the small vessels of the tumour irradiate it for a period of 3 months. .
Selective Internal Radiation Therapy or SIRT applied in large doses to the right lobe, controls the tumour and it also shrinks the right lobe. And in reaction to it, the left lobe expands. As a result, 3 months after a SIRT procedure, the liver resection or liver surgery can be performed safely, with the guarantee that enough liver will be left after the surgery.
- Right Portal Vein Embolisation
A right portal vein embolisation is another technique to grow one side of the liver, preparing for your liver surgery. As we commit to optimising our surgical outcomes, we also want to make sure you understand the treatments and techniques we use to prepare for your liver surgery. This particular treatment means that your interventional radiologist blocks the portal vein that feeds the right side of the liver. As a result, the blood flow now goes to the left side of the liver and it grows (and the right side of the liver shrinks). This process usually takes 4 to 6 weeks. A new CT scan is then performed to make sure there is now enough liver growth. This assures us that your surgery will now be safe to proceed.
Sometimes your surgeon will suggest a diagnostic staging laparoscopy as part of the required tests to make a thorough diagnosis. This is a laparoscopic procedure to collect extra information and imagery, on the extension of the primary tumour, the status of any metastases in the liver and the possibility of small cancer deposits in your abdomen. This procedure is used to establish that the planned surgery can proceed with the best possible long term result.
Fenestration of liver cysts
For large benign liver cysts laparoscopic fenestration can be performed where a large part of the capsule of the cyst is removed. This procedure will relieve the symptoms of compression of other organs by the cyst with a low rate of recurrence.
An intraoperative ultrasound is another procedure used by your liver specialist to locate tumours and large vessels inside the liver during surgery. The use of ultrasounds provides images with valuable information about the tumour location and the surgical anatomy of the liver.
TACE or Trans Arterial Chemo Embolisation is another technique that may be discussed as part of your recommended treatment pathway. A TACE procedure delivers chemotherapy medication via the hepatic artery (the blood vessels that lead into the liver and into a liver tumour). Beads are also injected to block most of the arterial supply of the tumour. This procedure is performed by highly specialised radiologists with whom we work closely together. This technique is sometimes used to control inoperable tumours.
Why The Liver Centre WA?
We are aware that our highly specialised surgery techniques may feel slightly overwhelming. That’s why we value clear communication as an essential part of our mission, when we set about helping you throughout your treatment journey. You will find that at any stage, your surgeon or specialist doctor will be here to help, or to provide extra clarification on each of the steps.
We want you to feel cared for and supported, before, during and after your surgery.
At The Liver Centre WA in Perth, we provide a wide range of liver treatment options and surgical procedures, as well as general surgery. You can rest assured that we commit not only to providing you with expert surgery, but also with a collective effort to support you and care for you as you need medical treatment.