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Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

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In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
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Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Related Experiment Video

Updated: Mar 16, 2026

Laparoscopic Anatomic S7+S8d Resection Preserving Inferior Right Hepatic Vein and S6 with Right Hepatic Vein Transection
06:00

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Published on: December 30, 2025

462

[Preoperative assessment for extended hepatic resection].

David Martin, Didier Roulin, Yamaguchi Takamune

    Revue Medicale Suisse
    |August 5, 2016
    PubMed
    Summary

    Major hepatectomy for liver cancer is increasing due to surgical advances. Preoperative assessment, including liver function and volume, is crucial for patient selection and safety.

    Area of Science:

    • Hepatobiliary Surgery
    • Surgical Oncology
    • Liver Transplantation

    Background:

    • Major hepatectomy, defined as resection of at least three liver segments, is increasingly performed for primary and secondary liver cancer.
    • Advances in anesthesiology, surgical techniques, radiological imaging, and perioperative care have expanded patient selection and improved safety.
    • Multidisciplinary tumor board discussion and comprehensive preoperative assessment are essential for successful outcomes.

    Purpose of the Study:

    • To describe the essential preoperative work-up for major hepatectomy.
    • To highlight the importance of evaluating biological, volumetric, and functional hepatic parameters.
    • To introduce strategies for managing insufficient liver remnant volume, such as portal vein embolization.

    Main Methods:

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    Laparoscopic Anatomical Liver Segment VII Resection with Liver Parenchymal Transection Following a Priority Approach
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    Laparoscopic Anatomical Right Hemihepatectomy via the In Situ Anterior Approach
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    • Review of current literature and clinical guidelines on preoperative assessment for major hepatectomy.
    • Discussion of key parameters including liver function tests, imaging (CT/MRI for volumetry), and functional assessments (e.g., ICG R15).
    • Explanation of the role of portal vein embolization in augmenting future liver remnant (FLR) volume.

    Main Results:

    • Preoperative assessment requires a combination of biological, volumetric, and functional evaluations.
    • Insufficient liver remnant volume can be addressed by preoperative portal vein embolization to induce hypertrophy.
    • Successful patient selection and surgical planning are critical for minimizing morbidity and mortality.

    Conclusions:

    • A thorough preoperative work-up is paramount for safe and effective major hepatectomy.
    • Integrating multidisciplinary input and advanced imaging/functional assessments optimizes patient selection.
    • Portal vein embolization is a valuable tool for increasing liver remnant volume when needed.