Liver Surgery Risks

Haemorrhage

Bleeding after hepatic surgery is a rare complication these days, affecting less than 1% of patients in experienced centres, and resolved by surgical re-exploration. Blood transfusion is avoided when possible as there is now considerable data to suggest that long-term outcomes may be compromised.

Abdominal Collections

Post- operative fluid collections following hepatic surgery are much more common, affecting up to 30% of patients in major series. Typical symptoms are abdominal pain, tenderness, discomfort, fever or increasing inflammatory markers. The treatment of choice is ultrasound or CT-guided percutaneous drainage so it is only rarely that surgical intervention will be needed.

Bile Leak

Recent evidence estimates the rate of bile leaks following hepatic resection remains around 7-8%. The evidence on risk factors associated with the incidence of bile leaks is scarce. A high percentage of bile leaks are treated by percutaneous drainage so re-operation isn’t usually necessary. Major high output bile leaks can be treated with specialist procedures (ERCP +/- stenting and sphincterotomy), but this is rarely required.

Venous Thromboembolism

This is when clots form in the veins if the legs (deep vein thrombosis – DVT) due to immobility during and following surgery. Special precautions have been shown to reduce the risks and these are used today – anti-thrombotic stockings, mechanical calf compression, and a small injection of a blood thinner each day are now routine.

Liver Failure

This is when the liver is failing to recover following surgery. This is very rare these days. You will be monitored carefully for liver failure following any liver surgery.