Current status of preoperative risk assessment for posthepatectomy liver failure in patients with hepatocellular carcinoma

© 2023 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery..

Liver resection is an effective therapeutic option for patients with hepatocellular carcinoma. However, posthepatectomy liver failure (PHLF) remains a major cause of hepatectomy-related mortality, and the accurate prediction of PHLF based on preoperative assessment of liver functional reserve is a critical issue. The definition of PHLF proposed by the International Study Group for Liver Surgery has gained acceptance as a standard grading criterion. Liver function can be estimated using a variety of parameters, including routine blood biochemical examinations, clinical scoring systems, dynamic liver function tests, liver stiffness and fibrosis markers, and imaging studies. The Child-Pugh score and model for end-stage liver disease scores are conventionally used for estimating liver decompensation, although the alternatively developed albumin-bilirubin score shows superior performance for predicting hepatic dysfunction. Indocyanine green clearance, a dynamic liver function test mostly used in Japan and other Asian countries, serves as a quantitative estimation of liver function reserve and helps determine indications for surgical procedures according to the estimated risk of PHLF. In an attempt to improve predictive accuracy, specific evaluation of liver fibrosis and portal hypertension has gained popularity, including liver stiffness measurements using ultrasonography or magnetic resonance elastography, as well as noninvasive fibrosis markers. Imaging modalities, including Tc-99m-labeled galactosyl serum albumin scintigraphy and gadolinium-enhanced magnetic resonance imaging, are used for preoperative evaluation in combination with liver volume. This review aims to provide an overview of the usefulness of current options for the preoperative assessment of liver function in predicting PHLF.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:7

Enthalten in:

Annals of gastroenterological surgery - 7(2023), 6 vom: 15. Nov., Seite 871-886

Sprache:

Englisch

Beteiligte Personen:

Nishio, Takahiro [VerfasserIn]
Taura, Kojiro [VerfasserIn]
Koyama, Yukinori [VerfasserIn]
Ishii, Takamichi [VerfasserIn]
Hatano, Etsuro [VerfasserIn]

Links:

Volltext

Themen:

Hepatocellular carcinoma
Journal Article
Liver fibrosis
Liver resection
Portal hypertension
Posthepatectomy liver failure
Review

Anmerkungen:

Date Revised 07.11.2023

published: Electronic-eCollection

Citation Status PubMed-not-MEDLINE

doi:

10.1002/ags3.12692

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM364197714