Introduction 

The liver is the largest solid organ in the body. It is unique in that it receives its blood supply from two sources. The blood pumped from the left side of the heart (as all other organs do) and the blood flow from all the organs of the gastrointestinal system (from oesophagus to rectum).

This fact makes the liver of crucial importance to the management of many conditions of the abdominal wall and its contents and so very important to the general surgeon whatever their subspeciality.

The livers functions are varied but primarily involve:

1. Protein synthesis
2. Excretion of waste products
3. Energy metabolism and storage
4. Immune system
5. Drug metabolism

The incidence of liver diseases in western populations is increasing largely as an effect of increasing alcohol consumption. These diseases and a wide variety of other conditions that affect the liver as a whole are treated by specialist gastroenterologists or hepatologists.

The general surgeon with a specialist interest in hepatobiliary (and pancreatic) surgery treats discreet abnormalities within the liver itself for the most part due to either benign (cystic or nodular conditions) or cancers.