Summary
After liver resections hepatocellular failure is one of the most severe postoperative syndromes. The risk of liver failure should be evaluated preoperatively by quantitative tests of hepatic function (e. g., galactose elimination capacity, sulfobromophthalein elimination, aminopyrine breath test). Treatment of liver failure, besides supportive therapy and the usual therapy for hepatic coma, includes the administration of special amino acid mixtures. After shunt operations portasystemic encephalopathy is the most important postoperative syndrome. So far it is not possible to prevent this syndrome by patient selection or special methods of shunt surgery. Effective therapeutic modalities are available, however.
Zusammenfassung
Nach Leberresektionen ist die Leberzellinsuffizienz eines der schwerwiegendsten postoperativen Syndrome. Das Risiko eines Leberversagens sollte mittels quantitativer Tests der Leberfunktion (z. B. Galaktoseeliminationskapazität, Bromsulphthaleinelimination, Aminopyrin-Atemtest) präoperativ erfaßt werden. Die Behandlung des Leberversagens umfaßt neben einer unterstützenden Therapie und neben der üblichen Komabehandlung auch die Gabe spezieller Aminosäurengemische. Nach Shuntoperationen ist die portosystemische Encephalopathie das wichtigste postoperative Syndrom. Bisher ist es nicht möglich, dieses Syndrom durch Patientenselektion oder durch spezielle Operationsmethoden zu verhindern. Für seine Behandlung stehen jedoch wirksame Therapieverfahren zur Verfügung.
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Paumgartner, G. 28. Hepatologische Gesichtspunkte. Langenbecks Arch Chiv 352, 145–147 (1980). https://doi.org/10.1007/BF01291989
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DOI: https://doi.org/10.1007/BF01291989