Liver
Understanding liver lesions
Many liver lesions are benign and are found incidentally. Common examples include haemangiomas, focal nodular hyperplasia and simple cysts. Most do not require treatment unless they cause symptoms or have concerning features.
Hepatocellular adenomas are less common but may require closer assessment because of risks including bleeding and malignant change.
Cancer
Primary and secondary liver tumours
Primary liver cancers include hepatocellular carcinoma and cholangiocarcinoma. The liver is also a common site of metastatic cancer, particularly from colorectal and other gastrointestinal tumours.
Treatment decisions depend on tumour type, size and location, underlying liver health and the patient’s overall fitness.
Investigation
Diagnosis and multidisciplinary review
Assessment may include blood tests, tumour markers and imaging with ultrasound, CT, MRI or PET. Biopsy is only required in selected situations. Complex cases are best reviewed through a multidisciplinary liver and cancer team.
Treatment
Surgery and other treatment options
Treatment may include liver resection, ablation, liver-directed therapies such as TACE or SIRT, systemic therapy and, in selected cases, transplantation. The most appropriate treatment depends on the diagnosis and the individual patient.
Pancreatic and bile duct conditions are assessed within the same hepatobiliary practice, with surgery considered where appropriate as part of a multidisciplinary treatment plan.
Recovery
After liver surgery
Recovery depends on the extent of surgery and the underlying liver condition. Hospital stay and return to full activity vary, with fatigue and reduced appetite common early after major liver surgery. The liver has a substantial capacity to regenerate after resection.
Discuss a referralRisks of liver surgery
Important risks and complications
Liver resection is major surgery and has general surgical risks as well as risks related specifically to removing part of the liver.
General risks
These include infection, bleeding, chest complications, heart attack or stroke, blood clots in the legs or lungs and the possibility of death. Risks are influenced by the extent of surgery, liver function and a patient’s other medical conditions.
Liver-specific risks
Specific risks include significant bleeding from the liver requiring transfusion or further surgery, bile leak requiring drainage or another procedure, and injury to the bile ducts. Bowel injury can cause leakage of bowel contents, peritonitis or sepsis and may require further surgery. Intra-abdominal infection, temporary bowel paralysis or obstruction, wound problems, hernia and adhesions can also occur.
The individual risk depends on the planned resection, underlying liver health and the patient’s overall condition.
Queensland Health NEMO nutrition guide
Nutrition after a Whipple’s procedure
Practical nutrition guidance for patients recovering after pancreaticoduodenectomy.