Hepatic resection: perioperative course and management

Normal liver can tolerate even a right trisegmentectomy with caudate resection which results' in a reduction of liver volume by 80%, while a decompensated cirrhotic liver cannot tolerate even partial hepatic resection. This can be ascribed to decreased functional volume and the deterioration of individual hepatocyte function, which is caused and amplified by inappropriate intraoperative procedures and postoperative management. Problems related to liver diseases, including liver cirrhosis, jaundice and chronic active hepatitis, operative techniques and postoperative management should be considered during hepatic resection. Pathophysiology and tactics for handling these problems will be described.