How much liver resection is too much?

Point-of-care continuous13C-methacetin breath test improves decision making in acute liver disease: Results of a pilot clinical trial

“…MBT has several advantages compared with the [6] is a major determinant of its outcome. Thus, the prognosis for ALF due to acetaminophen (paracetamol) overdose is relatively good, but the mortality rate for ALF from other causes may be significantly higher.…”

“…Decision-making in the treatment of patients with severe acute liver disease focuses on the early identification of patients that require liver transplantation. This identification is currently based on several clinical and laboratory parameters [4,5] , including clinical assessments, serum liver enzymes, synthetic tests, and serum ammonia levels; however, these parameters lack accuracy in assessing liver function [4,6] . In addition, frequent assessment of liver function is important in the follow-up and management of patients with severe acute liver diseases [2,[7][8][9] .…”

Metabolic signature of electrosurgical liver dissection

“…On the other hand, liver surgery remains a high risk procedure associated with complications such as postoperative haemorrhage, biliary leakage, impaired postoperative liver function, and even liver failure [4,5]. Although ES has markedly reduced these complications compared to older techniques, significant complications still occur in more than 50% of patients and mortality is estimated to be over 7% for extended resections [6][7][8]. There is considerable evidence from studies performed in the 1970ies and 80ies showing that mono-or bipolar ES adversely affects wound healing in general [3].…”

“…ES preparation induces significant thermic and oxidative damage to the liver. Clinically, this surgical trauma is associated with a typical decline in liver function during the immediate postoperative period and clearly affects patient survival [6,7] resulting from a loss of liver parenchymal reserve in addition to thermal injury to the remaining parenchyma. Thus, measures to minimize electro surgery-derived tissue trauma could potentially improve postop-erative outcomes.…”

Prediction of Indocyanine Green Retention Rate at 15 Minutes by Correlated Liver Function Parameters before Hepatectomy

“…In addition, evaluation of hepatic functional reserve has been developed and Child-Pugh classification is still widely applied worldwide [2][3][4]. However, it is sometimes difficult to plan the extent of hepatectomy by such a comprehensive scoring system consisting of the blood biochemical parameters for liver function without load for drug administration to the liver.…”