When is liver surgery a must?

Written by: Mr Charles Imber
Edited by: Conor Lynch

We were fortunate enough at Top Doctors to chat with highly regarded London-based consultant general surgeon, Mr Charles Imber, to discuss at length how liver surgery is performed, when it is the right time to undergo it, recovery time, and the associated risks.

When is liver surgery a must? Are there any alternatives that are as equally effective?

Alternative treatments range from simple observation for a condition that is not yet cancerous but that has the potential to become cancerous (an adenoma in the liver) through surgery to radiofrequency ablation.


Surgery allows the whole tumour to be removed and often guarantees a cure from liver cancer. Surgery is required to treat underlying liver conditions that might put patients at a higher risk of developing liver cancer. There are other treatment options, but surgery is far more effective.


Are there any patients who might not be suitable for liver surgery?

You certainly need to have underlying physiological reserve to withstand moderate to major surgery. We check that patients are fit enough for liver surgery. If they are not fit enough for this surgery, we can actually optimise their other medical conditions prior to liver surgery, so we can then perform it safely.


How exactly is it performed?

Patients are asleep during liver surgery. It involves incisions being made on the stomach, sometimes one large incision or multiple small incisions (if we are performing minimally invasive liver surgery) and it usually involves removal of parts of or all of the liver to remove a specific tumour.


We perform an ultrasound scan on the liver to detect where exactly the tumours are on the liver, and we then remove those tumours. We can also look for smaller tumours that may have not been seen on the scan.


We then cut out that piece of liver, and we use an instrument that cuts through the liver (bloodlessly). It almost cuts the liver like a book. We can preserve the rest of the liver, which then regenerates. We then close the abdomen area very carefully. Patients will then be transferred to an intensive care unit after the surgery for observation.


What are the main potential risks?

We need to ensure that there is no risk that the patient will be left with an insufficient amount of liver after parts of it is removed in the surgery. There is also a risk of bleeding, bile leaking from the cut surface, and infection.


What does recovery time entail?

Patients will generally have to spend four to five days in hospital following liver surgery. We won’t allow patients to be discharged from hospital until they are mobile, eating well, they are going to the toilet properly, and their wound is healing properly. It can be six to eight weeks at home to fully recover mentally and physically.


If you are set to undergo liver surgery in the near future, be sure to contact Mr Charles Imber today via his Top Doctors profile to find out all you need to know about the procedure before having it

By Mr Charles Imber

Mr Charles Imber is a prominent London-based consultant general surgeon with more than 20 years of experience working as a medical professional. He specialises in emergency surgery, gallbladder surgery, laparoscopic surgery, liver surgery, pancreas surgery, and hernias. He currently practises at the Cleveland Clinic London Hospital and the Cleveland Clinic London Rapid Access Gallbladder Unit.

After completing his medical studies at Manchester University and Cambridge University respectively, he began specialising in liver transplants, hepatobiliary surgery, and pancreatic surgery, working at hospitals in London, Cambridge, and Birmingham, before officially becoming a consultant surgeon in 2006. Impressively, Mr Imber was, in 2012, awarded a HCA Travelling Fellowship, after having previously been awarded numerous other notable awards, including the Presentation Travel Award from the International Liver Transplant Society, which he was awarded with in 2006. 

His other clinical interests include hernia surgery and gallbladder surgery. Always aiming to maximise patient care, he employs the use of the best technologies available, and is a pioneer of innovative mesh techniques for hernia repair. He is also an expert in both simple operations and more complicated cases, and has written extensively for peer-reviewed journals.

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