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Physiology and Anatomy of the Liver

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Liver Anesthesiology and Critical Care Medicine

Abstract

This chapter will review the anatomy and physiology of the liver relevant to anesthetic management during complex liver surgery. Anesthetic management of the patient with chronic liver disease requires an understanding of the alterations induced in cirrhosis that affect many organ systems. Liver surgery for ablation of tumors may reduce the functional mass of the liver resulting in systemic changes that alter hemodynamics and renal function. In liver transplantation, the body is deprived of all liver function during the implantation and may receive a new liver with impaired initial function. All types of liver surgery may accentuate hepatic ischemia with reperfusion, inducing systemic changes both acute and chronic. Thus, an understanding of the liver, and its structure and function, is critical in managing the changes of the liver induced during surgery. This knowledge, applied throughout the perioperative period by anesthesiologists with interest in liver disease, has been a major factor in the markedly improved outcomes of liver surgery during the past 50 years, and especially since the era of liver transplantation.

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Authors and Affiliations

  1. Department of Anesthesiology, Columbia University Medical Center, New York, NY, USA

    Teresa A. Mulaikal

  2. Department of Surgery, New York Presbyteria Hospital, Columbia University Medical Center, 622 West 168th Street, PH 14 East RM 103, New York, NY, 10032, USA

    Jean C. Emond

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Correspondence to Jean C. Emond .

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  1. , College of Physicians & Surgeons, Departments of Anesthesiology, of Columbia University, New York, 10032, New York, USA

    Gebhard Wagener

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Mulaikal, T.A., Emond, J.C. (2012). Physiology and Anatomy of the Liver. In: Wagener, G. (eds) Liver Anesthesiology and Critical Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5167-9_1

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