Current evidence on posthepatectomy liver failure: comprehensive review

Area of Science:

• Hepatobiliary Surgery
• Gastroenterology
• Transplantation Surgery

Background:

• Posthepatectomy liver failure (PHLF) persists as a critical clinical challenge in hepatobiliary surgery despite decades of advancements.
• Current literature lacks uniform reporting standards for PHLF due to varied definitions, hindering comparative analysis and progress.

Approach:

• A comprehensive literature review was conducted using PubMed, focusing on PHLF-related articles published until May 2022.
• Medical Subject Heading (MeSH) terms were employed to ensure a thorough and systematic search for relevant studies.

Key Points:

• There is no universal consensus on preoperative assessment methods to predict or prevent PHLF, despite efforts to estimate future liver remnant function.
• Effective treatments for established PHLF are limited, with liver transplantation being the primary option, though its availability and application are restricted.

Conclusions:

• Adherence to standardized definitions, such as the International Study Group of Liver Surgery criteria, is recommended for consistent PHLF reporting.
• Development of reliable methods for future liver remnant function assessment and broader accessibility of liver transplantation are crucial for managing severe PHLF.