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Defining Post Hepatectomy Liver Insufficiency: Where do We stand?

  • Review Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Post-hepatectomy liver failure (PHLF) is a major source of morbidity and mortality in patients undergoing liver resection. The aim of this review is to summarize the recent literature available on PHLF including its definition, predictive factors, preoperative risk assessment, severity grading, preventative measures, and management strategies.

Methods

A systematic literature search was carried out with the search engines PubMed, Medline, and Cochrane Database using the keywords related to “liver failure”, “posthepatectomy”, and “hepatic resection”.

Results

Liver resection is a curative treatment of liver tumors. However, it leads to concurrent death and regeneration of the remaining hepatocytes. Factors related to the patient, liver parenchyma and the extent of surgery can inhibit regeneration leading to PHLF.

Conclusion

Given its resistance to treatment and the high postoperative mortality associated with PHLF, great effort has been put in to both accurately identify patients at high risk and to develop strategies that can help prevent its occurrence.

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Authors and Affiliations

  1. Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Kelly Lafaro, Stefan Buettner, Hadia Maqsood, Doris Wagner, Fabio Bagante, Gaya Spolverato, Li Xu & Timothy M. Pawlik

  2. Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Kelly Lafaro

  3. Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Ihab Kamel

  4. Division of Surgical Oncology, John L. Cameron Professor of Alimentary Surgery, Department of Surgery, Johns Hopkins Hospital, 600 N. Wolfe Street, Blalock 688, Baltimore, MD, 21287, USA

    Timothy M. Pawlik

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  1. Kelly Lafaro
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Lafaro, K., Buettner, S., Maqsood, H. et al. Defining Post Hepatectomy Liver Insufficiency: Where do We stand?. J Gastrointest Surg 19, 2079–2092 (2015). https://doi.org/10.1007/s11605-015-2872-6

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