Prediction of the safe limits of hepatectomy by combined volumetric and functional measurements in patients with impaired hepatic function

Because of the vast functional reserve of the liver and its capacity to regenerate, an extensive hepatic resection to remove three of the four segments can be well tolerated by most patients with normal liver function. However, more than 70% of patients with hepatocellular carcinoma (HCC) have associated cirrhosis. In these patients such extensive hepatic resection has frequently resulted in fatal hepatic failure after surgery. Computed tomography (CT) has made possible a noninvasive, in-situ measurement of the volume of various organs in the body [1]. We have previously reported on our efforts to predict the safe limits of hepatectomy [2].