Assessment of hepatic reserve for the indication of hepatic resection: how I do it

Despite the careful selection of cirrhotic patients with hepatic neoplasms, liver resection for these patients remains associated with greater risk than in patients without underlying liver disease. The most rational indications for resective surgery in patients with hepatic neoplasms and cirrhosis...

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Published inJournal of Hepato‐Biliary‐Pancreatic Surgery Vol. 12; no. 1; pp. 27 - 30
Main Authors Gazzaniga, Gian Massimo, Cappato, Stefano, Belli, Fiorenza E., Bagarolo, Claudio, Filauro, Marco
Format Journal Article
LanguageEnglish
Published Japan 01.02.2005
Subjects
Algorithms
Biopsy
hepatectomy
Hepatectomy - methods
hepatic reserve
Humans
liver
Liver Cirrhosis - complications
Liver Failure - etiology
Liver Failure - prevention & control
Liver Function Tests - methods
Liver Neoplasms - complications
Liver Neoplasms - metabolism
Liver Neoplasms - surgery
Patient Selection
Risk Factors
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Summary:Despite the careful selection of cirrhotic patients with hepatic neoplasms, liver resection for these patients remains associated with greater risk than in patients without underlying liver disease. The most rational indications for resective surgery in patients with hepatic neoplasms and cirrhosis are nonprogressive cirrhosis and good functional reserve. Therefore, evaluation of hepatic reserve is mandatory for hepatectomy candidates. Because of the complexity of hepatic function, a single, reliable liver function test is not yet available. However, a good multifactorial system that combines several elements (clinical, laboratory, functional, and volumetric evaluation) does provide sufficient data for determining the safe limitis of hepatectomy.
ISSN:0944-1166
1868-6982
1436-0691
DOI:10.1007/s00534-004-0946-z