Post-hepatectomy liver failure

Hepatectomies are among some of the most complex operative interventions performed.Mortality rates after major hepatectomy are as high as 30%, with post-hepatic liver failure (PHLF)representing the major source of morbidity and mortality. We present a review of PHLF, includingthe current definition, predictive factors, pre-operative risk assessment, techniques to prevent PHLF,identification and management. Despite great improvements in morbidity and mortality, liver surgerycontinues to demand excellent clinical judgement in selecting patients for surgery. Appropriate choice ofpre-operative techniques to improve the functional liver remnant (FLR), fastidious surgical technique, andexcellent post-operative management are essential to optimize patient outcomes.