Quantitative Assessment of Hepatic Function and its Relevance to the Liver Surgeon

• Published in: Journal of gastrointestinal surgery Vol. 13; no. 2; pp. 374 - 385
• Main Authors: Morris-Stiff, G., Gomez, D., Prasad, R.
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.02.2009; Springer Nature B.V
• Subjects: Diagnostic Imaging; Gastroenterology; Hepatectomy; Humans; Liver cirrhosis; Liver Diseases - diagnosis; Liver Diseases - physiopathology; Liver Diseases - surgery; Liver Function Tests; Liver Transplantation; Medicine; Medicine & Public Health; Postoperative Care; Preoperative Care; Review Article; Studies; Surgery; Hepatic failure; Hepatocellular carcinoma; Hepatic neoplasms; Liver metastasis; Hepatectomy; Liver transplantation
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-008-0564-1

Background Standard evaluation of patients undergoing hepatic surgery has been through radiological and quantitative determination of liver function. As more complex and extensive surgery is now being performed, often in the presence of cirrhosis/fibrosis or following administration of chemotherapy, it is questioned whether additional assessment may be required prior to embarking on such surgery. The aim of this review was to determine the current knowledge base in relation to the performance of quantitative assessment of hepatic function both pre- and post-operatively in patients undergoing hepatic resectional surgery and liver transplantation. Methods An electronic search was performed of the medical literature using the MEDLINE database to identify relevant articles with cross-referencing of all identified papers to ensure full literature capture. Results and Conclusions The review has identified a number of different methods of dynamically assessing hepatic function, the most frequently performed being through the use of indocyanine green clearance. With the recent and further anticipated developments in hepatic resectional surgery, it is likely that quantitative assessment will become more widely practiced in order to reduce post-operative hepatic failure and improve outcome.