Contemporary methods for assessment of liver function for preventing postoperative liver failure
DOI:
https://doi.org/10.5281/zenodo.15278070Keywords:
postoperative liver failure, functional tests, future liver remnant, volumetryAbstract
INTRODUCTION: Post-hepatectomy liver failure (PHLF) is the most severe postoperative complication after this type of surgery with reported mortality rate, reaching 50% of cases. Preliminary assessment of the function offuture liver remnant (FLR) is crucial to determine the volume of liver resection.
METHODS OF MATERIAL: The literature review is prepared by a research of publications on the topic in PubMed / MEDLINE, EMBASE, Web of Science, CENTRAL, CDSR, DARE and Google Scholar.
RESULTS AND DISCUSSION: Methods for assessing liver function can be divided into quantitative and qualitative. Liver function is not necessarily related to liver volume and PHLF may occur, despite of the adequate volume of FLR. Dynamic functional tests can assess global liver function without being able to determine the functional capacity of the remnant. Magnetic resonance imaging with liver-specific contrast agents can assess both liver function and volume, but hepatobiliary scintigraphy allows accurate segmental liver assessment of residual liver.
CONCLUSION: Determination of the surgical strategy and the hepatectomy volume should be based on the results of the volumetry compiled with those of the liver functional tests. In clinical practice, several methods are used for functional evaluation of the liver and proved their usefulness and accuracy. The choice between them should be based on the individual characteristics of the patient and the center experience.
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