Update on Patient Management in Hepatic Surgery

Abstract

In the era of modern medicine, hepatic surgery knew radical changes allowing improvement in morbidity and mortality. Those results were possible due to the improvement made in each step of the management of the patient. Preoperatively, many techniques (such as volumetry, hepato-biliary scintigraphy, magnetic resonance relaxometry…) allow now the assessment of the volume and liver function, which is now a standard of care. In operation room, the combination of different techniques of clamping and new devices of hemostasis contributes to improve blood loss control. In general, morbi-mortality in hepatic surgery is related to the risk of hemorrhage, biliary fistula and postoperative liver failure (PHLF). In this article we propose to review recent literature concerning new techniques in the prevention of those 3 situations.