Liver cancer surgery (Surgery for liver cancer (resection or transplant))
Surgery to treat cancer in the liver, usually by removing the affected part (resection) and, for some people, by liver transplant, as part of a wider cancer plan.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- It treats cancer in the liver, usually by removing the affected part, and for some people by liver transplant.
- It is not always possible; it depends on the cancer's stage, how well the liver works, and your fitness.
- Surgery offers the best chance of long-term control for suitable cancers but cannot guarantee a cure.
- Treatment is planned by a specialist team using staging and liver tests, and is followed by long-term monitoring.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Offers the best chance of long-term control or cure for suitable liver cancers
The cancer has spread too widely, or there is too much disease in the liver, for surgery to help.
You are watched closely, often in a high-dependency or intensive care area at first, with pain relief, fluids and sometimes a drain. The team helps you...
Care in a specialist cancer and hepatobiliary centre with high-dependency support and a cancer nurse specialist.
You are watched closely, often in a high-dependency or intensive care area at first, with pain relief, fluids and...
Eating and drinking restart gradually and drains and tubes come out as you recover. People having keyhole...
Energy slowly returns and the liver regrows after resection. Tiredness and reduced appetite are normal. You build...
Most people recovering from resection return to normal activities with their surgeon's guidance. Follow-up scans...
What is liver cancer surgery?
Liver cancer surgery aims to remove or treat cancer in the liver. The cancer may have started in the liver (primary liver cancer, most often hepatocellular carcinoma, which frequently arises in a liver scarred by cirrhosis), or it may have spread to the liver from elsewhere, such as the bowel (secondary liver cancer).
The main operation is liver resection — removing the part of the liver containing the cancer, with a margin of healthy tissue around it. Because the liver can regrow, a substantial part can sometimes be removed safely, as long as enough healthy liver is left and it works well.
For some people with primary liver cancer and a cirrhotic liver, a liver transplant may be considered instead, replacing the whole liver. This is only suitable for selected patients who meet strict criteria, and depends on donor organ availability.
Surgery is rarely the whole story. The right treatment is decided by a specialist multidisciplinary team using staging (working out the size, number and spread of the cancer) and tests of how well the liver works. Surgery may be combined with other treatments. Importantly, surgery offers the best chance of long-term control for suitable cancers, but it cannot promise a cure.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Liver resection
Removing the part of the liver containing the cancer, with a clear margin, by open, keyhole or robotic surgery. The main operation for liver cancer when the liver will cope...
Liver transplant
For selected people with primary liver cancer in a cirrhotic liver, replacing the whole liver. Only suitable within strict criteria and limited by donor organ availability...
Surgery combined with ablation
When there are several tumours, surgery may be combined with ablation (destroying small tumours with heat) to clear the disease while keeping enough healthy liver.
Surgery for spread from the bowel
Cancer that has spread to the liver from the bowel can sometimes be removed if the disease is limited. This is planned with the wider cancer team and often combined with...
Preparing for your surgery
- Expect staging scans (CT, MRI and sometimes specialised liver imaging) to map the cancer and check whether it has spread.
- Your case is discussed by a specialist multidisciplinary team, who decide whether surgery, transplant or another treatment is best.
- You will have tests of how well your liver works, and of your kidneys, heart and lungs, to check you are fit for surgery.
- Tell your team about all medicines, especially blood thinners, and any allergies.
- Stop smoking as early as possible and follow advice on alcohol, which is especially important for the liver.
- Sometimes treatment is given first to shrink the cancer or to grow the part of the liver that will remain.
- Arrange help at home for several weeks (longer after a transplant), and ask about support services.
What happens
For a resection, you have a general anaesthetic. The surgeon either makes a cut across the upper abdomen or uses small cuts for keyhole or robotic surgery, frees the liver, controls its blood supply, and removes the part containing the cancer with a margin of healthy tissue. Modern techniques are used to limit bleeding. The removed tissue is sent to the laboratory to confirm the cancer type and whether the edges are clear.
A liver transplant is a larger operation in which the diseased liver is removed and replaced with a donor liver. It is followed by lifelong medicines to stop the body rejecting the new liver.
After surgery you are looked after closely, often in a high-dependency or intensive care area at first, with pain relief, fluids and careful monitoring. Drains, tubes and eating and drinking are managed step by step. Your specialist team co-ordinates any further cancer treatment.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- The cancer has spread too widely, or there is too much disease in the liver, for surgery to help.
- Too little healthy liver would be left, or the liver is too damaged by cirrhosis to cope with resection.
- You are not fit enough for major surgery and a long general anaesthetic.
- For transplant, you do not meet the strict criteria or are not suitable for lifelong anti-rejection medicines.
Delay surgery if…
- There is an active infection that should be treated first.
- Important heart, lung, kidney, liver-function or nutrition issues have not yet been optimised.
- Staging is incomplete, or the multidisciplinary team plan is not finalised.
- Treatment to shrink the cancer or grow the remaining liver is needed before surgery is safe.
Alternatives to discuss
- Ablation (heat treatment) for small tumours in suitable people.
- Embolisation or chemoembolisation (TACE) to block the tumour's blood supply.
- Targeted therapy or immunotherapy, such as combinations used for advanced disease.
- Radiotherapy techniques such as SABR or SIRT in selected cases.
- Best supportive (palliative) care focused on symptoms and quality of life when cure is not possible.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Offers the best chance of long-term control or cure for suitable liver cancers
- Removes or treats the cancer as part of a wider, planned approach
- Confirms the exact cancer type, extent and whether the edges are clear
- A transplant can treat both the cancer and the underlying liver disease in selected people
- Can be combined with other treatments to improve the chance of clearing the disease
Risks & complications
- Pain and tiredness for several weeks after major surgery
- A wound, and often a temporary drain
- A slow return of appetite and energy
- A hospital stay of several days, longer after a transplant
- Bile leaking from the cut surface of the liver
- Infection of the wound, chest or urine, or a collection inside the abdomen
- Bleeding needing a transfusion or, occasionally, a further procedure
- Blood clots in the legs or lungs
- Fluid building up in the abdomen (ascites)
- The remaining liver not working well enough afterwards (liver failure)
- Serious infection of the bloodstream (sepsis)
- Rejection of a transplanted liver, or side effects of anti-rejection medicines
- Death, which is uncommon but a recognised risk of major liver and transplant surgery
Risk depends on how much liver is removed, whether the rest of the liver is scarred by cirrhosis, the type of surgery, and your fitness. The most serious specific risks are bleeding, bile leak and the remaining liver not coping; transplant carries its own risks including rejection. This surgery is safest in specialist centres. Ask about your personal risk, the team's results, and what your staging means for the outlook.
Published figures to discuss
Both the risks of surgery and the long-term outlook vary widely with the type and stage of cancer, how much liver is removed, whether the liver is cirrhotic, and the patient's fitness. Survival figures depend heavily on stage and are not the same as a cure, and selection of who is offered surgery affects reported results. Figures are best treated as ranges discussed in the context of your own staging, and outcomes are generally better in specialist centres.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Death around the time of liver resection | Often quoted around 2% on average, lower for minor resections and higher for major resections or cirrhotic livers | Strongly dependent on the extent of surgery, liver health and fitness; transplant carries its own separate risks. | Surgical treatment of hepatocellular carcinoma — PMCpmc.ncbi.nlm.nih.govPublished figure |
| Bile leak after surgery | Reported in a wide range, from low single figures up to around 20% in some series | Varies with the type and size of resection; many leaks settle with a drain. | Surgical treatment of hepatocellular carcinoma — PMCpmc.ncbi.nlm.nih.govPublished figure |
| Cancer returning after surgery | Varies widely with type, stage and margins; recurrence is common and depends on the individual case | Why long-term follow-up matters; your team can explain the realistic outlook for your cancer. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
This is major cancer surgery and recovery is gradual. Keyhole resection often means a shorter hospital stay than open surgery; transplant recovery is longer. Most people recovering from resection feel back to themselves over a couple of months, while the liver regrows.
- Tiredness that lasts several weeks after major surgery
- A reduced appetite that slowly improves
- Some discomfort and numbness around the wound
- Emotional ups and downs while coming to terms with a cancer diagnosis and treatment
- Needing to pace yourself and rest more than usual at first
Aftercare
- Take pain relief as prescribed so you can move, breathe deeply and recover well.
- Walk a little and often to lower the risk of blood clots and chest infection.
- Look after your wound as advised and watch for signs of infection or bile leak.
- Eat little and often as your appetite returns, following any dietary advice.
- Avoid heavy lifting and strenuous activity until your surgeon says it is safe.
- Take all medicines exactly as directed; after a transplant, anti-rejection medicines are taken for life.
- Keep all follow-up appointments, including scans, blood tests and any further cancer treatment.
- Use the support available, and know the warning signs and who to contact if you become unwell.
- Help at home arranged for several weeks (longer after transplant)
- Comfortable clothing that does not press on the wound
- A clear list of medicines and pain relief
- Written wound-care and warning-sign instructions
- Follow-up appointment, scan and blood-test dates noted
- Clinic, cancer nurse specialist and out-of-hours contact numbers saved
- Transport arranged, as you will not be able to drive at first
Scars and how they heal
Open liver surgery usually leaves a scar across the upper abdomen, sometimes in an upside-down V or J shape, which fades over months but does not disappear. Keyhole or robotic surgery leaves several smaller scars. Numbness around the scar is common at first. Your surgeon can show you what to expect.
⚠ Get urgent help if…
- A high temperature, shivering or feeling cold and shaky (signs of infection)
- Yellowing of the skin or eyes, with dark urine and pale stools
- Severe or worsening tummy pain or swelling
- Increasing redness, swelling or discharge from the wound
- Green or yellow fluid leaking from the wound or drain
- A swollen, painful calf, or breathlessness or chest pain (possible clot)
- Confusion, severe drowsiness or being unable to keep fluids down
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A successful operation removes the cancer (or replaces the liver in a transplant). After resection, examining the tissue confirms the cancer type, its extent, and whether the edges (margins) were clear, all of which help guide what happens next.
For cancer, surgery is one important part of a wider plan. Even a complete removal with clear margins does not guarantee the cancer will not return, because cancer can come back in the liver or elsewhere. This is why staging, margins, any additional treatment and long-term follow-up all matter. Your team will explain what your particular results mean and discuss the realistic outlook honestly.
The outlook after liver cancer surgery depends on the type and stage of the cancer, whether the margins were clear, the health of the rest of the liver (especially if there is cirrhosis), and whether the cancer has spread. There is always a chance of the cancer returning, which is why follow-up continues over a planned period. For people with primary liver cancer and cirrhosis, the underlying liver disease also affects long-term health. Your team can give you a realistic picture for your situation, while being honest about uncertainty.
Combining with other procedures
Liver cancer surgery is often part of a combination of treatments. It may follow or precede chemotherapy, targeted therapy or immunotherapy, and surgery can be combined with ablation when there are several tumours. Treatments to shrink the cancer, block its blood supply (embolisation) or grow the remaining liver may be used before surgery. The specialist team plans the order to give the best chance of controlling the disease.
Follow-up & long-term care
After surgery you will be followed up closely by the cancer and hepatobiliary teams, usually with regular scans and blood tests over a planned period to watch for any return of the cancer, and to manage the health of your liver. Any further treatment is arranged through this follow-up. You should have a cancer nurse specialist or clear point of contact, and know how to get help quickly if you become unwell.
- Regular follow-up scans and blood tests to watch for the cancer returning.
- Monitoring of liver function, especially if the rest of the liver is scarred.
- Any additional cancer treatment, such as chemotherapy or targeted therapy, as planned.
- After a transplant, lifelong anti-rejection medicines and regular monitoring.
- Lifestyle and alcohol advice to protect the liver, and prompt review of any new symptoms.
Revision and secondary surgery reality
- The cancer can return in the liver or elsewhere and may need further treatment or, sometimes, repeat surgery or ablation.
- A bile leak or collection may need a drain or a further procedure.
- If too little liver would be left, a staged approach or a procedure to grow the remaining liver may be needed first.
- Long-term scans and blood tests are an essential part of care, not optional.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- Care in a specialist cancer and hepatobiliary centre with high-dependency support and a cancer nurse specialist.
- A named contact and out-of-hours route for fever, jaundice, bleeding or worsening pain.
- A clear, written follow-up plan with scans and blood tests over the long term.
- Joined-up care between surgery, oncology, hepatology, your GP and support services.
- Honest discussion of recurrence risk, realistic outlook and access to psychological and palliative support when needed.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether the surgery is a resection (and how extensive) or a transplant
- Whether keyhole, robotic or open surgery is used
- The surgeon's and specialist team's fees
- Theatre time and the facility (hospital) fee
- The general anaesthetic and the anaesthetist's involvement
- Length of hospital stay, including high-dependency or intensive care
- Staging scans, pathology and any additional cancer treatment such as chemotherapy
- The surgeon's fee and the facility (hospital) fee
- The anaesthetic cost
- An estimate of the hospital stay, including higher-dependency care
- Staging scans, pathology (tissue analysis) and results reporting
- Follow-up appointments, scans and any additional cancer treatment
- What happens, and what it costs, if a complication occurs or further treatment is needed
- The cancellation policy
On the NHS? Liver cancer surgery is provided on the NHS in specialist cancer and hepatobiliary centres when clinically indicated; private care may be used for choice of specialist, speed or a second opinion, but treatment should always be planned by a specialist multidisciplinary team.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Implying surgery is a guaranteed cure for cancer.
- Not explaining the stage of the cancer and what it means for the outlook.
- Underplaying that this is major surgery with a small but real risk to life.
- No discussion of alternatives such as ablation, embolisation or drug treatments.
- Not making clear that long-term follow-up and possibly further treatment are needed.
Marketing red flags
- Promising a cure or a guaranteed outcome from liver cancer surgery.
- Describing major cancer surgery as routine or low-risk.
- Recommending surgery without a multidisciplinary team, full staging and imaging.
- Downplaying recurrence, the role of the rest of the liver, or the need for follow-up.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- What type and stage is my liver cancer, and what does that mean for treatment and outlook?
- Is resection or a transplant suitable for me, or is another treatment better?
- How much of my liver would be removed, and will enough healthy liver be left?
- Will I need chemotherapy or other treatment before or after surgery?
- What is the chance the cancer comes back, and how will you check for it?
- How experienced are you and your unit with this type of liver cancer surgery?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Will surgery cure my liver cancer?
Can everyone with liver cancer have surgery?
What is the difference between resection and a transplant?
Why do I need so many tests and a team meeting first?
Will I need chemotherapy or other treatment as well?
How long is the recovery?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Liver cancer (treatment) Cancer Research UK — Treatment options for liver cancer Cancer Research UK — Surgery for liver cancer Cancer Research UK — Problems after liver cancer surgery Surgical treatment of hepatocellular carcinoma — PMC
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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