1. Assessment and optimization of liver volume before major hepatic resection: Current guidelines and a narrative review.
- Author
-
Khan AS, Garcia-Aroz S, Ansari MA, Atiq SM, Senter-Zapata M, Fowler K, Doyle MB, and Chapman WC
- Subjects
- Embolization, Therapeutic adverse effects, Embolization, Therapeutic methods, Female, Humans, Ligation adverse effects, Ligation methods, Liver surgery, Liver Regeneration, Male, Portal Vein surgery, Practice Guidelines as Topic, Preoperative Care methods, Risk Factors, Treatment Outcome, Vascular Surgical Procedures adverse effects, Hepatectomy adverse effects, Liver physiopathology, Liver Failure etiology
- Abstract
Post hepatectomy liver failure (PHLF) remains a significant cause of morbidity and mortality after major liver resection. Although the etiology of PHLF is multifactorial, an inadequate functional liver remnant (FLR) is felt to be the most important modifiable predictor of PHLF. Pre-operative evaluation of FLR function and volume is of paramount importance before proceeding with any major liver resection. Patients with inadequate or borderline FLR volume must be considered for volume optimization strategies such as portal vein embolization (PVE), two stage hepatectomy with portal vein ligation (PVL), Yttrium-90 radioembolization, and associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). This paper provides an overview of assessing FLR volume and function, and discusses indications and outcomes of commonly used volume optimization strategies., (Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF