Preoperative Assessment and Optimization of the Future Liver Remnant

Surg Clin North Am. 2016 Apr;96(2):197-205. doi: 10.1016/j.suc.2015.11.001. Epub 2016 Feb 16.

Abstract

Liver resection of benign, primary, and metastatic tumors is challenging and places patients at risk for postoperative liver insufficiency. The magnitude of this risk largely depends on the volume and function of the future liver remnant (FLR). It is, therefore, critical that hepatobiliary surgeons are well versed in measurement of liver volume and function as well as various techniques for preoperative liver volume augmentation. The absolute volume of FLR required to avoid postoperative liver insufficiency depends on patient, disease, and anatomic factors. Rapid expansion of the FLR can safely be achieved with portal venous embolization of the contralateral liver segments.

Keywords: Chemotherapy-associated hepatotoxicity; Liver cancer; Liver metastases; Liver surgery; Portal vein embolization; Steatosis.

Publication types

  • Review

MeSH terms

  • Embolization, Therapeutic / methods
  • Hepatectomy / methods*
  • Humans
  • Liver / pathology
  • Liver / physiopathology
  • Liver Neoplasms / pathology*
  • Liver Neoplasms / surgery*
  • Organ Size
  • Postoperative Complications / etiology
  • Preoperative Care