Hepatectomy: Preoperative Analysis of Hepatic Function and Postoperative Liver Failure

Most authors reporting on hepatectomy stress the importance of preoperative assessment of liver function and functional reserve to minimize the surgical risk, especially in patients with liver cirrhosis, jaundice or those undergoing prolonged chemotherapy [1] since it is these patients who have a markedly increased risk of developing liver failure [2–5]. According to a recent review, liver failure is the major cause of death after hepatectomy followed in importance by intraoperative and postoperative hemorrhage and sepsis accounting for 38, 29 and 21% of deaths, respectively [6]. For this reason it is of paramount importance to estimate liver function preoperatively and to predict postoperative remaining functional liver parenchymal mass and its reserve.