Hackl, Christina and Schlitt, Hans J. and Renner, Philipp and Lang, Sven A. (2016) Liver surgery in cirrhosis and portal hypertension. WORLD JOURNAL OF GASTROENTEROLOGY, 22 (9). pp. 2725-2735. ISSN 1007-9327, 2219-2840
Full text not available from this repository. (Request a copy)Abstract
The prevalence of hepatic cirrhosis in Europe and the United States, currently 250 patients per 100000 inhabitants, is steadily increasing. Thus, we observe a significant increase in patients with cirrhosis and portal hypertension needing liver resections for primary or metastatic lesions. However, extended liver resections in patients with underlying hepatic cirrhosis and portal hypertension still represent a medical challenge in regard to perioperative morbidity, surgical management and postoperative outcome. The Barcelona Clinic Liver Cancer classification recommends to restrict curative liver resections for hepatocellular carcinoma in cirrhotic patients to early tumor stages in patients with Child A cirrhosis not showing portal hypertension. However, during the last two decades, relevant improvements in preoperative diagnostic, perioperative hepatologic and intensive care management as well as in surgical techniques during hepatic resections have rendered even extended liver resections in higher-degree cirrhotic patients with portal hypertension possible. However, there are few standard indications for hepatic resections in cirrhotic patients and risk stratifications have to be performed in an interdisciplinary setting for each individual patient. We here review the indications, the preoperative risk-stratifications, the morbidity and the mortality of extended resections for primary and metastatic lesions in cirrhotic livers. Furthermore, we provide a review of literature on perioperative management in cirrhotic patients needing extrahepatic abdominal surgery and an overview of surgical options in the treatment of hepatic cirrhosis.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SPONTANEOUS BACTERIAL PERITONITIS; HEPATIC VASCULAR EXCLUSION; SMALL HEPATOCELLULAR-CARCINOMA; INDOCYANINE GREEN CLEARANCE; PREOPERATIVE PLATELET COUNT; RANDOMIZED CLINICAL-TRIAL; MAJOR SURGICAL CHALLENGE; CENTRAL VENOUS-PRESSURE; LONG-TERM SURVIVAL; DTPA-ENHANCED MRI; Liver resection; Hepatocellular carcinoma; Liver metastases; Portal hypertension; Cholangiocellular carcinoma; Cirrhosis |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie |
| Depositing User: | Petra Gürster |
| Date Deposited: | 01 Sep 2020 06:15 |
| Last Modified: | 01 Sep 2020 06:15 |
| URI: | https://pred.uni-regensburg.de/id/eprint/3261 |
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