Summary:
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Most people researching liver surgery focus on hospital reputation and cost. Very few think to ask their surgeon two simple questions: how well planned are your liver resections, and what are the longer-term outcomes for typical or similar patients?
These questions matter more than most patients realise. Read on to know what else you should consider when evaluating your surgeon and the questions you should ask before you commit to anything.
What to Look for in a Liver Resection Surgeon
Specialist qualifications and hepatobiliary training
Ask directly: where did they train, and for how long, specifically in liver surgery?
Not every general surgeon is equipped to perform liver resection. You are looking for a surgeon with specific training in hepatobiliary (relating to the liver, bile ducts, and gallbladder) surgery, often written as HPB surgery. This subspecialty requires advanced fellowship training beyond a standard surgical qualification, typically completed after a general surgery residency.
At Digestive & Liver Surgery, both senior consultant surgeons hold HPB and Transplant subspecialty training.
Dr Victor Lee Tswen Wen completed his fellowship at the Royal Infirmary of Edinburgh, while Dr Tan Ek Khoon trained at the Mayo Clinic in the United States.
Experience
A surgeon may have performed hundreds of abdominal operations and still have limited experience with liver resection surgery. High volume of surgery or procedures may not necessarily translate to good outcomes for individual patients.
There is an important element of teamwork required for such technical procedures, and surgeons who pool their expertise and collaborate across specialities generally achieve better outcomes for their patients, compared to individual surgeons.
Access to minimally invasive and robotic techniques
Minimally invasive liver resection, including laparoscopic liver resection and robotic-assisted approaches, is available for suitable cases at experienced centres.
Compared to traditional open surgery, laparoscopic hepatectomy in Singapore (surgical removal of the affected portion of the liver through small incisions) is associated with reduced blood loss, less post-operative discomfort, and shorter hospital stays for suitable patients.
These techniques are not suitable for every case or tumour location, so ask what proportion of the surgeon’s cases are performed this way, and when they would recommend open surgery instead.
Once you have assessed the surgeon, the next question is whether the hospital around them can support the standard of care you need.
Why the Hospital Matters as Much as the Surgeon
Infrastructure, multi-disciplinary support, and post-operative care
Liver surgery is not performed in isolation. The outcome depends heavily on the infrastructure around the surgeon: the quality of the anaesthetic team, access to blood products, and the capacity to manage intraoperative complications.
Hospitals that perform liver surgery regularly develop institutional competence, and protocols for managing bile leaks or post-hepatectomy liver failure (PHLF, a serious condition where the remaining liver tissue is insufficient to maintain normal function) are well-rehearsed rather than improvised.
If your resection is being performed in the context of cancer, you may also require a multidisciplinary team (MDT) reviewing your case before surgery. A case that is not reviewed by an MDT is a case managed in relative isolation. You want to know who is in that room, and whether your surgeon is directly contactable if something changes after discharge.
The following criteria give you a practical framework for that assessment:
| What to check | What good looks like |
| Surgical volume | The hospital performs a high number of liver resections annually and has established HPB protocols |
| Multidisciplinary team | Your case is reviewed by oncologists, radiologists, pathologists, anaesthetists, and HPB surgeons together before surgery |
| Post-operative infrastructure | A dedicated HDU or ICU with experience in post-hepatectomy care; nursing staff trained in post-operative liver monitoring |
How Do You Compare Hospitals for Liver Surgery in Singapore?
Singapore’s restructured hospitals, including Singapore General Hospital, National University Hospital, and Tan Tock Seng Hospital, are all JCI (Joint Commission International) accredited and offer established HPB surgical programmes.
Private hospitals such as Gleneagles Hospital and Mount Elizabeth Orchard Hospital also host experienced liver surgeons within a dedicated hepatobiliary unit, many of whom spent significant time in their professional careers in Singapore’s restructured hospitals.
Studies show that hospitals performing higher volumes of liver resections annually tend to have more refined protocols and lower rates of in-hospital mortality. Ask specifically how many liver resections the hospital performs each year, and confirm it has a dedicated ICU or HDU.
Patients recovering from laparoscopic liver resection or open surgery may require close monitoring of liver function markers and haemodynamic stability (blood pressure and circulatory function) for 48 to 72 hours or longer.
In Singapore, outcomes data for individual surgeons are not publicly published. You can, however, ask the clinic directly for data on complication rates and 30-day readmission rates, and check whether the surgeon has published peer-reviewed research or is a member of bodies such as the Asia-Pacific Hepato-Pancreato-Biliary Association (A-PHPBA) or International Hepato-Pancreato-Biliary Association (IHPBA).
The Questions Every Patient Should Ask Before Liver Surgery
Use the following questions to guide your consultation, organised by the area of the surgeon’s practice they address:
| Category | Questions to ask |
| The surgeon’s experience | Have you operated on cases similar to mine in terms of location, size, and complexity? |
| The procedure and your case | What is the surgical goal: curative resection, palliative debulking, or another objective? Will my case be reviewed at an MDT meeting before the operation? |
| Surgical approach | Am I a candidate for laparoscopic or robotic liver resection? If open surgery is recommended, what is the reasoning for my case? |
| Recovery, risks, and outcomes | What are the most likely complications, and how would they be managed? What does recovery look like in the first week and over the following months? |
Red Flags to Watch Out For
Be cautious if any of the following apply after your consultation:
- The surgeon could not or would not share about their liver resection experience
- Surgeon doesn’t communicate CT or MRI scans well during the preoperative planning, and doesn’t make an effort to personalise your care
- Complications and risks were downplayed, avoided, or dismissed as unlikely. No effort was made for pre-operative planning with relevant blood tests, and cardiorespiratory assessment for major surgery.
- You left without a clear picture of where you will recover, who monitors you, and who to contact if something changes after discharge
Ready to Take the Next Step?
Choosing the right surgeon for liver resection surgery takes time, and that time is worth taking. The questions in this guide are a starting point, not an exhaustive checklist, and your instinct during a consultation matters too. If something feels unclear or rushed, it is entirely reasonable to seek a second opinion.
At Digestive & Liver Surgery, Dr Victor Lee and Dr Tan Ek Khoon are HPB and Transplant-trained surgeons who perform liver cancer surgery and minimally invasive liver resection across four locations in Singapore, including Gleneagles Hospital and Mount Elizabeth Orchard Hospital, where the clinic’s HPB surgeons consult.
