Overview
Take only what you need — keep what is healthy.
A partial right hepatectomy removes one or two segments of the right liver rather than the entire right lobe. The most common variations are the right posterior sectionectomy (removing segments 6 and 7) and the right anterior sectionectomy (removing segments 5 and 8). Single-segment resections — for example, a segment 7 segmentectomy — are also possible when anatomy permits. The principle is the same in all of them: remove the disease with a clean margin while saving as much healthy liver as possible.
Parenchyma-sparing surgery has become the standard of care for many liver tumors. Patients recover faster, have fewer complications, and — critically — have plenty of healthy liver left over if new disease appears later and needs another operation, ablation, or chemotherapy. For colorectal liver metastases in particular, where the average patient may need more than one liver operation over the course of their treatment, this matters a great deal.
Who is a candidate?
Anyone whose disease can be removed with negative margins by taking one or two segments. Colorectal liver metastases, hepatocellular carcinoma in a single section, neuroendocrine metastases, and symptomatic benign lesions are common indications. We confirm with CT or MRI mapping that the tumor does not invade the vessels of the right liver's other section — because if it does, a full right hepatectomy may be needed instead. Multidisciplinary tumor board review is part of every case.
How we perform it
You are asleep under general anesthesia. Most cases are done laparoscopically or robotically through four to five small ports. Intraoperative ultrasound confirms the tumor location and maps the vessels supplying each segment. We isolate and divide the segmental or sectional pedicle (artery, portal vein branch, bile duct) and watch for the line of color change that marks the transection plane. The liver is divided using ultrasonic dissection and energy sealing, controlling each branch as we go. The cut surface is checked for bleeding and bile leak before closing.
Recovery
Most patients stay 3–5 days in the hospital. You will walk and start a regular diet the day after surgery. Pain is generally well controlled with a combination of nerve blocks and oral medication. We follow up at 2 weeks, repeat labs at 6 weeks, and image at 3 months. Most patients return to normal work and exercise by 4–6 weeks, and full strength returns within 2–3 months.
Why Florida Surgical
Dr. Shaw is fellowship-trained in hepato-pancreato-biliary (HPB) surgery and surgical oncology. We have specific experience with minimally invasive sectionectomy and segmentectomy and use intraoperative ultrasound on every liver case to confirm anatomy in real time. For colorectal liver metastases we plan resection together with medical oncology — sometimes alternating chemotherapy and surgery — because the long-term plan matters as much as the day-of-surgery plan.
Frequently asked questions
Why partial instead of total?
Whenever cancer or another problem can be removed with a clean margin by taking only the involved segments instead of the whole right lobe, we choose the smaller operation. Less liver removed means easier recovery, less risk of post-hepatectomy liver insufficiency, and more liver in reserve for future treatment if needed.
How do you decide which segments to remove?
We map the tumor and the blood vessels on CT or MRI before surgery, then confirm in the operating room with intraoperative ultrasound. The two most common partial right resections are posterior sectionectomy (segments 6 and 7) and anterior sectionectomy (segments 5 and 8). Single-segment resections are also possible when anatomy allows.
Is this done minimally invasively?
In most cases yes. Anterior segments (5 and 8) are particularly suitable for laparoscopic and robotic approach. Posterior segments (6 and 7) are deeper and need experience, but a minimally invasive approach is still feasible in many cases.
What is the recovery like?
Most patients stay 3–5 days in the hospital — shorter than for a total right hepatectomy. Light activity at one week, return to most normal activities at 4–6 weeks.
Can I have more liver surgery later?
Yes. Parenchyma-sparing resection is one of the main reasons we prefer it — there is plenty of healthy liver left for re-operation, ablation, or another resection if new disease appears, which is particularly important for colorectal metastases.