Systematic review of pathophysiological changes following hepatic resection

Area of Science:

• Hepatobiliary Surgery
• Surgical Physiology
• Postoperative Care

Background:

• Major hepatic resection is a common surgical procedure with inherent risks.
• Significant pathophysiological changes occur post-resection, impacting patient outcomes.
• Understanding these changes is vital for managing patients undergoing liver surgery.

Purpose of the Study:

• To review the pathophysiological changes following major hepatic resection.
• To identify interventions that mitigate risks and adverse outcomes.
• To provide insights into managing post-resection liver failure.

Main Methods:

• Literature search of MEDLINE, EMBASE, and CENTRAL databases (2000-2011).
• Keywords included 'hepatectomy', 'liver function', 'liver failure', and 'physiology'.
• Review of relevant studies on physiological alterations after liver resection.

Main Results:

• Predictable biochemical and coagulation changes are observed post-hepatectomy.
• Deviations from expected physiological responses indicate a complex recovery.
• Key sequelae include sepsis susceptibility, renal impairment, and metabolic disturbances.

Conclusions:

• The pathophysiology of post-resection liver failure is challenging to reverse.
• Preventive strategies are paramount for reducing morbidity and mortality.
• Focus on proactive management to improve patient survival after liver surgery.