Consent: Liver Resection

Note: This article is for educational purposes only. It should not be used as a template for consenting patients. The person obtaining consent should have clear knowledge of the procedure and the potential risks and complications. Always refer to your local or national guidelines.

Overview of Procedure

Liver resection is performed for tumour excision. It varies in the extent, from simple wedge excisions to major resections involving entire lobes of the liver

Complications

Intraoperative

Complication Description of Complication Potential Ways to Reduce Risk
Haemorrhage The liver is very vascular and may bleed, as well as any other surrounding structure.  
Injury to surrounding structures including bowel, bladder and ureter, liver, spleen Damage can occur to any surrounding organ during the surgery. Decompress the bladder with a catheter
Anaesthetic risks Includes damage to the teeth, throat and larynx, reaction to medications, nausea and vomiting, cardiovascular and respiratory complications. Forms a part of the anaesthetist assessment before the operation

Early

Complication Description of Complication Potential Ways to Reduce Risk
Pain   The patient will most likely have an epidural or patient controlled analgesia for post-operative control
Infection Superficial wound infections or intra-abdominal collections are both possible. Chest infections are common, most often due to reduced lung expansion secondary to pain Peri-operative antibiotics will reduce the risk of wound infections.  Early mobilisation, optimal analgesia, and encouraging breathing exercises reduces the risk of lower respiratory tract infections
Post-operative liver failure If the liver remnant is not sufficient to maintain normal physiology, then the patient may develop over-whelming liver failure. A minimum of 2 contiguous perfused and drained liver segments accounting for 25-30% by volume (>40% in cirrhotics) should be left to prevent this.
Bile leak Bile may leak from the cut surfaces of the liver, or from damage to the bile ducts, which may require drainage.  
Scarring An incision will result in a scar, which may develop as a keloid scar, particular in high-risk ethnicities  
Blood Clots DVTs and PEs are a possibility in any operation. The risk is increased in patients with a raised BMI, on the pill, recent flights, previous DVT, pregnancy, smokers, cancer and prolonged bed rest. The patient will be given anti-embolism stocking and low molecular weight heparin peri-operatively to minimise this risk as deemed appropriate.
Stroke, MI, Kidney Failure, Death Although small, this is always a risk in any major surgery  

Late

Complication Description of Complication Potential Ways to Reduce Risk
Adhesions Abdominal surgery may cause adhesions as a reaction to the procedure, which in turn can cause adhesional bowel obstruction  
Recurrence There is always a potential for further surgery due to recurrence of the tumour.  

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