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, and the applicable and appropriate law in your jurisdiction governing patient consent.
Overview of Procedure
Liver resection is most commonly 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. |