Assessment and optimization of liver volume before major hepatic resection: Current guidelines and a narrative review

作者：Khan Adeel S^*; Garcia Aroz Sandra; Ansari Mohammad A; Atiq Syed M; Senter Zapata Michael; Fowler Kathryn; Doyle M B; Chapman W C

来源：International Journal of Surgery, 2018, 52: 74-81.

DOI：10.1016/j.ijsu.2018.01.042

• Extended hepatectomy
• Future liver remnant
• Functional liver volume
• Liver volume optimization
• Portal vein embolization
• ALLPS
• Associating liver partition and portal vein ligation
• Portal vein ligation
• Two stage hepatectomy

Post hepatectomy liver failure (PHLF) remains a significant cause of morbidity and mortality after major liver resection. Although the etiology of PHLF is multifactorial, an inadequate functional liver remnant (FLR) is felt to be the most important modifiable predictor of PHLF. Pre-operative evaluation of FLR function and volume is of paramount importance before proceeding with any major liver resection. Patients with inadequate or borderline FLR volume must be considered for volume optimization strategies such as portal vein embolization (PVE), two stage hepatectomy with portal vein ligation (PVL), Yttrium-90 radioembolization, and associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). This paper provides an overview of assessing FLR volume and function, and discusses indications and outcomes of commonly used volume optimization strategies.

• 出版日期2018-4