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HPB Surgery
Volume 11 (2000), Issue 5, Pages 285-297
http://dx.doi.org/10.1155/2000/31945

Review: Research Toward Safer Resection of the Cirrhotic Liver

1Liver Diseases Unit, Departments of Surgery, Medicine, and Pharmacology, University of Manitoba, Winnipeg, Manitoba, Canada
2Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
3Liver Diseases Unit, Health Sciences Center, 820 Sherbrook Street, Winnipeg R3A 1R9, Manitoba, Canada

Received 10 November 1998

Copyright © 2000 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Despite recent advances in hepatic surgery, resection of the cirrhotic liver continues to be fraught with high morbidity and mortality rates. As a result, for many patients requiring resection of HCC the postoperative course is complicated and the probability of cure is diminished by coexisting cirrhosis. In this review, we discuss the characteristics of the cirrhotic liver which make it poorly tolerant of resection and the most common complications that follow such surgery. The main purpose of this paper is to review recent attempts to identify interventions that might be beneficial to cirrhotic patients undergoing resection. These interventions include assessment of liver reserve, advances in surgical technique, and improvement in liver function and regeneration.