Liver resection for cancer: New developments in prediction, prevention and management of postresectional liver failure

Abstract

Liver failure is the main cause of death after partial liver resection for cancer, and is presumably caused by an insufficient quantity and function of the liver remnant. Detection of liver failure is often too late, and current treatment focuses on relieve of symptoms. New research initiatives explore artificial support of liver function and stimulation of regrowth of the remnant liver.

A novel glucagon‐like peptide 1/glucagon receptor dual agonist improves steatohepatitis and liver regeneration in mice

“…Partial hepatectomy (PH) is an alternative to liver transplantation as it induces hepatic regeneration and repopulation of the damaged liver with healthy hepatocytes. Despite the lack of randomized clinical trials comparing PH and liver transplant, PH circumvents organ shortage and long waiting periods associated with disease progression, being highly relevant for hepatocellular carcinoma patients . According to the scientific registry of transplant recipients, NASH‐related cirrhosis is currently the third most common indication for liver transplantation in the United States, surpassed only by hepatitis C virus and alcohol‐related cirrhosis.…”

“…Despite the lack of randomized clinical trials comparing PH and liver transplant, (5) PH circumvents organ shortage and long waiting periods associated with disease progression, being highly relevant for hepatocellular carcinoma patients. (6) According to the scientific registry of transplant recipients, (7) NASH-related cirrhosis is currently the third most common indication for liver transplantation in the United States, surpassed only by hepatitis C virus and alcohol-related cirrhosis. In addition, PH is a potentially curative treatment for patients with resectable liver tumors, (8) but as liver regeneration is impaired in NASH patients, (9) new therapeutic approaches are needed to spur a controlled regenerative response of the liver in this pathological condition.…”

Systematic review of the influence of chemotherapy-associated liver injury on outcome after partial hepatectomy for colorectal liver metastases

“…Parenchymal damage due to chemotherapy can be diagnosed before surgery by radiological and biochemical means, as reviewed recently in detail. Despite (experimental) research focusing on CALI, little evidence is available for its treatment in the human setting. When liver injury is confirmed before operation, surgeons are thus advised to adapt surgical management to prevent complications.…”

Effectiveness comparison of indocyanine green retention test with the cirrhotic severity scoring in evaluating the pathological severity of liver cirrhosis in patients with hepatocellular carcinoma and Child-Pugh grade A liver function

“…However, in China, more than 80% of patients develop HCC in the background of cirrhosis [3]. Posthepatectomy liver failure (PHLF) resulting from the insufficient residual liver function is one of the most serious complications for HCC patients undergoing hepatic resection [4,5], and the incidence of PHLF is significantly associated with cirrhotic severity [6]. Therefore, preoperative evaluation of cirrhotic severity is of significant importance before making a surgical treatment strategy.…”