Hepatic Resections

Abstract

Hepatic resection is applicable for a wide variety of space-occupying abnormalities of the liver. Broadly, if nonoperative management fails and a refractory localized process persists within the liver, resection is indicated. Significant metabolic reserve and regenerative capacity of the liver permit a wide variety of resections. The major consideration in determining resectability is whether the extent of resection will leave sufficient functioning liver. Factors relevant to the hepatic mass which affect resectability include number, size, and location of lesions. Those factors relevant to hepatic function which affect resectability include the presence or absence of acute or chronic liver disease, biliary obstruction, or compromise of the hepatic vasculature. Preoperative assessment of patients must address each of these considerations.

Editor’s Note: This chapter written by David M. Nagorney, MD, Associate Professor of Surgery, Department of Gastroenterologic and General Surgery, Mayo Clinic and Foundation, Rochester, MN, USA.