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Post-hepatectomy Liver Failure

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Optimizing Outcomes for Liver and Pancreas Surgery

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Abstract

Among postoperative complications associated with liver surgery, such as infections, fluid collections, deep venous thrombosis, bleeding, and bile leak, liver insufficiency/failure is typically the most life-threatening condition. In fact, post-hepatectomy liver failure (PHLF) can be the cause of serious morbidity and mortality after liver resection, especially among patients with fibrosis or cirrhosis of the underlying liver. Several risk factors for PHLF have been described, including patient characteristics, liver quality and volume, as well as intraoperative variables.

PHLF is a life-threatening condition that can lead to a cascade of events including coagulopathy, ascites, HE, respiratory, cardiac, and renal complications. An accurate assessment of the anatomy and the FLR reserve, as well as impeccable intraoperative technique and detailed postoperative care, are all critical in avoiding and managing PHLF.

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Authors and Affiliations

  1. Department of Surgery, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA

    Gaya Spolverato MD, Fabio Bagante MD & Timothy M. Pawlik MD, MPH, PhD

  2. Department of Surgery, University of Verona, Verona, Italy

    Gaya Spolverato MD & Fabio Bagante MD

Authors
  1. Gaya Spolverato MD
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  2. Fabio Bagante MD
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  3. Timothy M. Pawlik MD, MPH, PhD
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Correspondence to Timothy M. Pawlik MD, MPH, PhD .

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Editors and Affiliations

  1. Virginia Mason Medical Center, Seattle, Washington, USA

    Flavio G. Rocha

  2. Wake Forest Baptist Health, Winston-Salem, North Carolina, USA

    Perry Shen

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Spolverato, G., Bagante, F., Pawlik, T.M. (2018). Post-hepatectomy Liver Failure. In: Rocha, F., Shen, P. (eds) Optimizing Outcomes for Liver and Pancreas Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-62624-6_7

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