Systematic review of pathophysiological changes following hepatic resection

作者:Siu Joey; McCall John; Connor Saxon*
来源:Hepato Pancreato Biliary, 2014, 16(5): 407-421.
DOI:10.1111/hpb.12164

摘要

ObjectivesMajor hepatic resection is now performed frequently and with relative safety, but is accompanied by significant pathophysiological changes. The aim of this review is to describe these changes along with interventions that may help reduce the risk for adverse outcomes after major hepatic resection. MethodsThe MEDLINE, EMBASE and CENTRAL databases were searched for relevant literature published from January 2000 to December 2011. Broad subject headings were hepatectomy/', liver function/', liver failure/' and physiology/'. ResultsPredictable changes in blood biochemistry and coagulation occur following major hepatic resection and alterations from the expected path indicate a complicated course. Susceptibility to sepsis, functional renal impairment, and altered energy metabolism are important sequelae of post-resection liver failure. ConclusionsThe pathophysiology of post-resection liver failure is difficult to reverse and thus strategies aimed at prevention are key to reducing morbidity and mortality after liver surgery.

  • 出版日期2014-5