Liver failure is a dreaded and often fatal complication that sometimes follows a partial hepatic resection.
Dr Maartje van den Broek and colleagues from the Netherlands evaluated the definition, incidence, pathogenesis, risk factors, risk assessment, prevention, clinical features and treatment of post-resectional liver failure.
|The reported incidence of post-resectional liver failure ranges between 0.7 and 9%|
The team performed a systematic, computerized search using key words related to ‘partial hepatic resection' and ‘liver failure'."
The researchers reviewed the most relevant literature about post-resectional liver failure published in the last 20 years.
The researchers found that the reported incidence of post-resectional liver failure ranges between 0.7 and 9%.
An inadequate quantity or quality of residual liver mass are key events in its pathogenesis.
Major risk factors are the presence of comorbid conditions, pre-existent liver disease and small remnant liver volume.
The team noted that it is essential to identify these risk factors during the pre-operative assessment that include evaluation of liver volume, anatomy and function.
Preventive measures should be applied whenever possible as curative treatment options for post-resectional liver failure are limited.
The research team observed that these preventive measures intend to increase remnant liver volume and protect remnant liver function.
Management principles focus on support of end-organ and liver function.
Dr van den Broek's team concluded, "Further research is needed to elucidate the exact pathogenesis of post-resectional liver failure and to develop and validate adequate treatment options."