Preoperative CT volumetric analysis to plan liver resection for hepatocellular carcinoma on cirrhosis

Liver resective surgery: a multivariate analysis of postoperative outcome and complication

“…As we have recently reported in our series for ChildPugh B and C, an estimated liver remnant volume (ELRV) lesser than 50% is associated with high mortality in the first year and no survival after the third year compared with an ELRV>50% [18]. The preoperative liver remnant volume estimation led us to plan the surgical procedure in such a way as to both obtain a radical result and not make the liver function worse.…”

“…Recent studies revealed that a liver remnant volume lesser than 25% is associated with an increased incidence of postoperative hepatic dysfunction in patients with normal liver, but liver resection on cirrhosis must conserve about 50% of total liver volume to preserve liver function [18][19][20].…”

“…It has been demonstrated that massive hemorrhage during partial hepatectomy contributes to morbidity and mortality [14,17,18]. Besides, subsequent blood transfusion facilitates recurrence of hepatic malignancies, including both primary and secondary tumors, and decreases survival of patients [38].…”

Liver Resection for Hepatocellular Carcinoma: a Multivariate Analysis of Factors Associated with Improved Prognosis. the Role of Clinical, Pathological and Surgical Related Factors

“…We recently evaluate our results on the ground of the extension of resected volume, in particular we recognized that a resection that involve over 50% of total liver volume results to be a negative prognostic factor for in-hospital mortality, survival and rising liver dysfunction 26 .…”