Liver failure after partial hepatic resection: pathophysiology,risk factors and treatment

Liver failure is a dreaded and often fatal complication that sometimes follows partial hepatectomy.This article reviews the pathophysiology, risk factors and treatment of post-resectional liver failure (PLF). An inadequate quantity or quality of residual liver mass are the key event in its pathogenesis. The major risk factors are small remnant liver volume (RLV), excessive blood loss or transfusion, ICGR15 of greater than 20%, and F4/F3 liver cirrhosis. It is essential to identify these risk factors during the pre-operative assessment. Preventive measures should be applied whenever possible as options of curative treatment for PLF are limited. Artificial liver and/or liver transplantation are the important treatment alternatives for hepatic failure after hepatectomy. Key words: Hepatectomy; Hepatic failure; Treatment