Postoperative Liver Dysfunction and Future Remnant Liver: Where Is the Limit?

Abstract

Hepatectomy can be considered safe when FRL is >26.5% in patients with healthy liver and >31% in patients with impaired liver function.

Parenchymal-sparing hepatectomies (PSH) for bilobar colorectal liver metastases are associated with a lower morbidity and similar oncological results: A propensity score matching analysis

“…The main causes of liver failure remain chemotherapy-induced liver injury 36 and a small future remnant liver. [37][38][39][40] Considering progress made in chemotherapy, the reduction in the number of chemotherapy cycles could well represent one of the solutions to reduce liver failure in the future. On the other hand, a parenchymal-sparing approach seems to be the best solution to preserve a sufficient quantity of functional parenchyma, to reduce postoperative risks of liver failure to a minimum as demonstrated by Narita.…”

Differences in Perioperative Outcomes Between Right and Left Hepatic Lobectomy

“…Several other studies have noted the higher rate of pleural effusions, venous thromboembolism in patients undergoing right hepatic lobectomy [15][16][17]. Furthermore, it is known that morbidity and mortality after hepatic resection for malignancy is strongly associated with volume of the future liver remnant [18]. It is likely that the smaller future liver remnant following right hepatic lobectomy contributes to the worse perioperative outcomes as echoed by many other studies involving living donors undergoing right hepatectomies [13,19,20].…”

Portveneembolisering før kirurgi av leversvulster

“…Spesielt gjelder dette ved tumoraffeksjon av begge leverlapper. Sannsynligvis bør leverresten ikke vaere mindre enn 25 % av det totale levervolum (12). Våre data viser en enda lavere median verdi for leverresten.…”