Hepatic functional reserve and surgical indication in primary liver cancer
Radical hepatectomy is the most effective means of treatment for hepatocellular carcinoma (HCC), however a number of HCC patients who also have cirrhosis show a deterioration of hepatic function after hepatectomy, some developing ostoperative hepatic insufficiency [1, 2, 3]. Approximately 20 years ago, one of us pointed out that the indication of hepatectomy for HCC associated with cirrhosis was remarkably limited and its determination should be based on a preoperative estimation of hepatic functional reserve 4]. Since then, hepatectomy has been successfully performed even on cirrhotic patients in accordance with their individual preoperative risk factors at various medical institutions in Japan. This has resulted in longer survival as well as decreased mortality and morbidity after surgery.
KeywordsHepatic Resection Cirrhotic Patient Disseminate Intravascular Coagulation Transcatheter Arterial Embolization Remnant Liver
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