Liver surgery
Specialist liver surgery
Liver surgery is Mr Bell’s main area of NHS practice at St James’s University Hospital, where he performs liver resections (removal of part of the liver) for primary (starting in the liver) and metastatic (secondary) liver tumours, along with surgery for benign (non-cancerous) hepatobiliary (liver, gallbladder and bile duct) disease as well as more routine hernia and gallbladder surgery.
A “lesion” found on a scan
With more people having ultrasound, CT and MRI scans, small liver abnormalities are often found by chance. The word “lesion” simply means an area that looks different – it is not a diagnosis. Most turn out to be harmless, but the uncertainty can be difficult to live with. A specialist review of your imaging usually gives a clear answer quickly, and where further tests are needed, Mr Bell will explain why.
Liver cysts and benign tumours
Simple liver cysts, haemangiomas (tangles of small blood vessels), focal nodular hyperplasia (FNH – an overgrowth of normal liver cells) and adenomas (non-cancerous growths of liver cells) are common and most need no treatment. Surgery may be recommended when a lesion causes symptoms, grows, or carries a risk of complications. Some of these operations can be performed by keyhole surgery.
Liver cancer and liver metastases
Surgery offers the best chance of long-term control for many patients with cancer confined to the liver, including:
- Colorectal (bowel) cancer that has spread to the liver
- Hepatocellular carcinoma (primary liver cancer)
- Cholangiocarcinoma (bile duct cancer) and gallbladder cancer
- Selected other tumours that have spread to the liver
Cancer treatment is planned through a specialist multidisciplinary team (surgeons, cancer specialists, radiologists and specialist nurses who review each case together). Mr Bell can see you privately to discuss whether surgery is possible, to give a second opinion on a proposed plan, and to explain where treatment is best delivered for your circumstances.
Liver resection
A liver resection removes the part of the liver containing the disease. Because the liver regenerates, a substantial proportion can be removed safely in the right patient. Mr Bell’s research has examined how to make major liver surgery safer – including techniques to grow the remaining liver before an operation – and how to help patients recover faster afterwards.
For GPs and consultants: imaging reports and referral letters can be sent to admin@rbell-surgery.com. Mr Bell is happy to discuss cases by phone.
Common questions
My scan showed a liver lesion. Should I be worried?
Most liver lesions picked up by chance on scans are benign, such as cysts or haemangiomas. A specialist review of the imaging usually clarifies what it is and whether anything further is needed.
Can the liver grow back after surgery?
Yes. A healthy liver regenerates after part of it is removed, usually regaining much of its volume within weeks. This is what makes surgery possible even when a large portion of the liver is affected.
Can you give a second opinion on liver cancer treatment?
Yes. Mr Bell sees patients privately for a second opinion on whether liver surgery is possible, and can review scans and reports from other hospitals.
Will I need a referral?
A referral letter from your GP or treating consultant is helpful, especially for cancer care, as it allows Mr Bell to review your history and imaging in advance.