Perioperative medicine & outcomes
E-AHPBA–ESSO–ESSR Innsbruck consensus guidelines for preoperative liver function assessment before hepatectomy
Methodological detailsmodified Delphi, systematic literature search, SIGN methodology
- Modified Delphi
- Systematic literature search
- SIGN methodology
Recommendations
As issued by the authors
Preoperative liver function assessment should be considered before complex resections, and in patients with suspected or known underlying liver disease, or chemotherapy-associated or drug-induced liver injury.
Clinical assessment and blood-based scores reflecting liver function or portal hypertension (e.g. albumin/bilirubin, platelet count) aid in identifying risk of posthepatectomy liver failure (PHLF).
Volumetry of the future liver remnant is the foundation for assessment, combinable with indocyanine green clearance or LiMAx® according to local expertise and availability.
Functional MRI and liver scintigraphy are alternatives, combining FLR volume and function in one examination.
Original publication
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