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What Is the Best Way to Assess Hepatic Reserve Prior to Liver Resection in the Cirrhotic Patient?

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Difficult Decisions in Hepatobiliary and Pancreatic Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

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Abstract

Postoperative liver failure still remains a major cause of mortality after partial hepatectomy, which results from an insufficient functional remnant liver. Therefore, the accurate evaluation of liver function is very important, particularly in cirrhotic patients who require hepatectomy. Traditional tests, such as serological indicators, Child-Pugh score, MELD score and ICG clearance test, are important in predicting and reducing the risks of hepatectomy. However, these tests only provide functional data on the entire liver, not on specific anatomic parts of the liver. Ideally, assessments of liver function should include both anatomical information and function of the whole and partial liver, providing reliable information for accurate evaluation of surgical risks. 99mTc-galactosyl serum albumin scintigraphy, can assess the liver function quantitatively. It combined with single photon emission computed tomography, CT and three-dimensional reconstruction, may be a better measure of liver function, especially of remnant liver function.

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Author information

Authors and Affiliations

  1. Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, 1# Shuai-Fu-Yuan, Wang-Fu-Jing, Beijing, 100730, China

    Yilei Mao & Shunda Du

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  1. Yilei Mao
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  2. Shunda Du
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Correspondence to Yilei Mao .

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Editors and Affiliations

  1. The University of Chicago, CHICAGO, Illinois, USA

    J. Michael Millis

  2. The University of Chicago, CHICAGO, Illinois, USA

    Jeffrey B. Matthews

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Mao, Y., Du, S. (2016). What Is the Best Way to Assess Hepatic Reserve Prior to Liver Resection in the Cirrhotic Patient?. In: Millis, J., Matthews, J. (eds) Difficult Decisions in Hepatobiliary and Pancreatic Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-319-27365-5_14

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  • DOI: https://doi.org/10.1007/978-3-319-27365-5_14

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