What are the differences between right hepatectomy and left hepatectomy?

Generally, the differences between right and left hepatectomy mainly lie in the extent of resection, surgical difficulty, postoperative recovery speed, impact on liver function, and applicable disease types. The specific surgical approach must be determined by doctors based on a comprehensive assessment of the patient's condition. Detailed analysis is as follows:

1. Extent of Resection

The right lobe of the liver accounts for approximately 60%–70% of the total liver volume, so more tissue is removed during right hepatectomy; the left lobe accounts for about 30%–40%, resulting in a relatively smaller resection range. Due to the difference in the amount of tissue removed, there is a significant difference in the impact on the overall liver structure.

2. Surgical Difficulty

The vascular distribution within the right liver lobe is more complex, and it is adjacent to organs such as the gallbladder and duodenum, which limits the surgical operating space and increases the technical difficulty. In contrast, the left lobe is more superficially located and has a simpler vascular anatomy, making left hepatectomy less technically challenging than right hepatectomy.

3. Postoperative Recovery Speed

Due to smaller surgical trauma and milder impact on liver function, patients undergoing left hepatectomy typically experience earlier recovery of gastrointestinal function and earlier mobilization after surgery, with an overall recovery period of about 1–2 months. After right hepatectomy, patients require a longer time to restore liver function, face slightly higher risks of postoperative complications, and generally have a recovery period of about 2–3 months.

4. Impact on Liver Function

The right liver lobe performs a greater share of metabolic and detoxification functions. After its removal, the remaining liver tissue must compensate for more complex physiological demands, leading to more noticeable fluctuations in liver function tests, which require close monitoring. Following left hepatectomy, the compensatory burden on the remaining liver tissue is smaller, resulting in relatively stable and milder fluctuations in liver function parameters and a more stable recovery process.

5. Applicable Disease Types

Right hepatectomy is commonly performed for primary liver cancer in the right lobe, large hepatic hemangiomas in the right lobe, intrahepatic bile duct stones in the right lobe, and similar lesions. Left hepatectomy is suitable for diseases confined to the left lobe, such as left-sided hepatocellular carcinoma, left lobe intrahepatic bile duct dilation, and benign tumors in the left lobe.

In addition, regardless of the surgical approach selected, patients should undergo thorough preoperative evaluation of liver function and imaging studies to assess liver reserve capacity. Postoperatively, patients must strictly follow medical advice regarding diet, starting with liquid or semi-liquid foods and gradually transitioning to a regular diet. Alcohol consumption should be avoided to reduce liver burden, and regular follow-up evaluations of liver function and liver imaging are necessary to monitor recovery progress.