Skip to main content
Top
Published in: European Surgery 3/2018

Open Access 01-06-2018 | main topic

Perioperative management of liver surgery—review on pathophysiology of liver disease and liver failure

Authors: Lukas Gasteiger, Stephan Eschertzhuber, Werner Tiefenthaler

Published in: European Surgery | Issue 3/2018

Login to get access

Summary

An increasing number of patients present for liver surgery. Given the complex pathophysiological changes in chronic liver disease (CLD), it is pivotal to understand the fundamentals of chronic and acute liver failure. This review will give an overview on related organ dysfunction as well as recommendations for perioperative management and treatment of liver failure-related symptoms.
Literature
1.
go back to reference Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish JP. Miller’s anesthesia. 8th ed. Churchill Livingston: Elsevier; 2014. Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish JP. Miller’s anesthesia. 8th ed. Churchill Livingston: Elsevier; 2014.
2.
go back to reference Morgan GE Jr, Mikhail MS, Murray MJ. Clinical anesthesiology. 4th ed. 2006. Morgan GE Jr, Mikhail MS, Murray MJ. Clinical anesthesiology. 4th ed. 2006.
3.
go back to reference Kristensen, et al. 2014 ESC/ESA guidelines noon n‑cardiac surgery: cardiovascular assessment and management. Eur Heart J. 2014;35:2383–431.CrossRefPubMed Kristensen, et al. 2014 ESC/ESA guidelines noon n‑cardiac surgery: cardiovascular assessment and management. Eur Heart J. 2014;35:2383–431.CrossRefPubMed
4.
go back to reference Iwakiri YY, Groszmann RJ. The hyperdynamic circulation of chronic liver diseases: from the patient to the molecule. Hepatology. 2006;43:S121–S31.CrossRefPubMed Iwakiri YY, Groszmann RJ. The hyperdynamic circulation of chronic liver diseases: from the patient to the molecule. Hepatology. 2006;43:S121–S31.CrossRefPubMed
6.
go back to reference Bolognesi M, Di Pascoli M, Verardo A, Gatta A. Splanchnic vasodilation and hyperdynamic circulatory syndrome in cirrhosis. World J Gastroenterol. 2014;20(10):2555–63.CrossRefPubMedPubMedCentral Bolognesi M, Di Pascoli M, Verardo A, Gatta A. Splanchnic vasodilation and hyperdynamic circulatory syndrome in cirrhosis. World J Gastroenterol. 2014;20(10):2555–63.CrossRefPubMedPubMedCentral
7.
go back to reference Mookerjee RP, Balasubramaniyan V, Mehta G. ADMA and hepatic endothelial dysfunction in cirrhosis—the DDAH isoform is the key. Liver Int. 2012;32:1186. author reply 1187.CrossRefPubMed Mookerjee RP, Balasubramaniyan V, Mehta G. ADMA and hepatic endothelial dysfunction in cirrhosis—the DDAH isoform is the key. Liver Int. 2012;32:1186. author reply 1187.CrossRefPubMed
8.
go back to reference Mookerjee RP, Vairappan B, Jalan R. The puzzle of endothelial nitric oxide synthase dysfunction in portal hypertension: the missing piece? Hepatology. 2007;46:943–6.CrossRefPubMed Mookerjee RP, Vairappan B, Jalan R. The puzzle of endothelial nitric oxide synthase dysfunction in portal hypertension: the missing piece? Hepatology. 2007;46:943–6.CrossRefPubMed
9.
go back to reference Herz S, Puhl G, Spies C, Jörres D, Neuhaus P, von Heymann C. Perioperatives anästhesiologisches Management bei ausgedehnten Leberteilresektionen. Anaesthesist. 2011;60:103–17.CrossRefPubMed Herz S, Puhl G, Spies C, Jörres D, Neuhaus P, von Heymann C. Perioperatives anästhesiologisches Management bei ausgedehnten Leberteilresektionen. Anaesthesist. 2011;60:103–17.CrossRefPubMed
11.
go back to reference Ruiz-del-Árbol L, Monescillo A, Arocena C, et al. Circulaztory function and hepatorenal syndrome in cirrhosis. Hepatology. 2005;42:439–47.CrossRefPubMed Ruiz-del-Árbol L, Monescillo A, Arocena C, et al. Circulaztory function and hepatorenal syndrome in cirrhosis. Hepatology. 2005;42:439–47.CrossRefPubMed
12.
go back to reference Arroyo V, Gine’s P, Alexander L, Gerbes AL, Dudley FJ, Gentilini P, et al. Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. International Ascites Club. Hepatology. 1996;23:164–76.CrossRefPubMed Arroyo V, Gine’s P, Alexander L, Gerbes AL, Dudley FJ, Gentilini P, et al. Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. International Ascites Club. Hepatology. 1996;23:164–76.CrossRefPubMed
13.
go back to reference Fernandez-Seara J, Prieto J, Quiroga J, Zozaya JM, Cobos MA, Rodriguez-Eire JL, et al. Systemic and regional hemodynamics in patients with liver cirrhosis and ascites with and without functional renal failure. Gastroenterology. 1989;97:1304–12.CrossRefPubMed Fernandez-Seara J, Prieto J, Quiroga J, Zozaya JM, Cobos MA, Rodriguez-Eire JL, et al. Systemic and regional hemodynamics in patients with liver cirrhosis and ascites with and without functional renal failure. Gastroenterology. 1989;97:1304–12.CrossRefPubMed
14.
go back to reference Sagi S, Mittal S, Kasturi KS, Sood GK. Terlipressin therapy for reversal of type 1 hepatorenal syndrome: a meta-analysis of randomized controlled trials. J Gastroenterol Hepatol. 2010;25:880–5.CrossRefPubMed Sagi S, Mittal S, Kasturi KS, Sood GK. Terlipressin therapy for reversal of type 1 hepatorenal syndrome: a meta-analysis of randomized controlled trials. J Gastroenterol Hepatol. 2010;25:880–5.CrossRefPubMed
16.
go back to reference Ramsay M. Portopulmonary hypertension and right heart failure in patients with cirrhosis. Curr Opin Anaesthesiol. 2010;23:145–50.CrossRefPubMed Ramsay M. Portopulmonary hypertension and right heart failure in patients with cirrhosis. Curr Opin Anaesthesiol. 2010;23:145–50.CrossRefPubMed
17.
go back to reference Hoeper MM, Krowka MJ, Strassburg CP. Portopulmonary hypertension and hepatopulmonary syndrome. Lancet. 2004;363:1461–8.CrossRefPubMed Hoeper MM, Krowka MJ, Strassburg CP. Portopulmonary hypertension and hepatopulmonary syndrome. Lancet. 2004;363:1461–8.CrossRefPubMed
18.
go back to reference Krowka MJ, Miller DP, Barst RJ, et al. Portopulmonary hypertension-a report from the US-based REVEAL registry. Chest. 2012;141(4):906–15.CrossRefPubMed Krowka MJ, Miller DP, Barst RJ, et al. Portopulmonary hypertension-a report from the US-based REVEAL registry. Chest. 2012;141(4):906–15.CrossRefPubMed
19.
go back to reference Krowka MJ, Swanson KL, Frantz RP, et al. Portopulmonary hypertension: results from a 10-year screening algorithm. Hepatology. 2006;44:1502–10.CrossRefPubMed Krowka MJ, Swanson KL, Frantz RP, et al. Portopulmonary hypertension: results from a 10-year screening algorithm. Hepatology. 2006;44:1502–10.CrossRefPubMed
20.
go back to reference Maithel SK, Kneuertz PJ, Kooby DA, et al. Importance of low preoperative platelet count in selecting patients for resection of hepatocellular carcinoma: a multiinstitutional analysis. J Am Coll Surg. 2011;212:638–48.CrossRefPubMedPubMedCentral Maithel SK, Kneuertz PJ, Kooby DA, et al. Importance of low preoperative platelet count in selecting patients for resection of hepatocellular carcinoma: a multiinstitutional analysis. J Am Coll Surg. 2011;212:638–48.CrossRefPubMedPubMedCentral
21.
go back to reference Weeder PD, Porte RJ, Lisman T. Hemostasis in liver disease: implications of new concepts for perioperative management. Transfus Med Rev. 2014;28:107–13.CrossRefPubMed Weeder PD, Porte RJ, Lisman T. Hemostasis in liver disease: implications of new concepts for perioperative management. Transfus Med Rev. 2014;28:107–13.CrossRefPubMed
22.
go back to reference Lisman T, Porte R. Rebalanced hemostasis in patients with liver disease: evidence and clinical consequences. Blood. 2010;116:878–85.CrossRefPubMed Lisman T, Porte R. Rebalanced hemostasis in patients with liver disease: evidence and clinical consequences. Blood. 2010;116:878–85.CrossRefPubMed
23.
go back to reference Tripodi A, Salerno F, Chantarangkul V, et al. Evidence of normal thrombin generation in cirrhosis despite abnormal conventional coagulation tests. Hepatology. 2005;41:553–8.CrossRefPubMed Tripodi A, Salerno F, Chantarangkul V, et al. Evidence of normal thrombin generation in cirrhosis despite abnormal conventional coagulation tests. Hepatology. 2005;41:553–8.CrossRefPubMed
24.
go back to reference Lisman T, Bakhtiari K, Pereboom IT, Hendriks HG, Meijers JC, Porte RJ. Normal to increased thrombin generation in patients undergoing liver transplantation despite prolonged conventional coagulation tests. J Hepatol. 2010;52:355–61.CrossRefPubMed Lisman T, Bakhtiari K, Pereboom IT, Hendriks HG, Meijers JC, Porte RJ. Normal to increased thrombin generation in patients undergoing liver transplantation despite prolonged conventional coagulation tests. J Hepatol. 2010;52:355–61.CrossRefPubMed
25.
go back to reference Stravitz RT. Potential applications of thromboelastography in patients with acute and chronic liver disease gastroenterology. Hepatology. 2012;8(8):513–20. Stravitz RT. Potential applications of thromboelastography in patients with acute and chronic liver disease gastroenterology. Hepatology. 2012;8(8):513–20.
26.
go back to reference Hoetzel A, Ryan H, Schmidt R. Anesthetic considerations for the patient with liver disease. Curr Opin Anaesthesiol. 2012;25:340–7.CrossRefPubMed Hoetzel A, Ryan H, Schmidt R. Anesthetic considerations for the patient with liver disease. Curr Opin Anaesthesiol. 2012;25:340–7.CrossRefPubMed
28.
go back to reference O’Connor Z, Zafirova M. Hepatic encephalopathy: current management strategies and treatment, including management and monitoring of cerebral edema and intracranial hypertension in fulminant hepatic failure. Curr Opin Anaesthesiol. 2010;23:121–7.CrossRefPubMed O’Connor Z, Zafirova M. Hepatic encephalopathy: current management strategies and treatment, including management and monitoring of cerebral edema and intracranial hypertension in fulminant hepatic failure. Curr Opin Anaesthesiol. 2010;23:121–7.CrossRefPubMed
29.
31.
32.
go back to reference Ginés P, Quintero E, Arroyo V, Terés J, Bruguera M, Rimola A, Caballería J, Rodés J, Rozman C. Compensated cirrhosis: natural history and prognostic factors. Hepatology. 1987;7:122–8.CrossRefPubMed Ginés P, Quintero E, Arroyo V, Terés J, Bruguera M, Rimola A, Caballería J, Rodés J, Rozman C. Compensated cirrhosis: natural history and prognostic factors. Hepatology. 1987;7:122–8.CrossRefPubMed
33.
go back to reference Planas R, Montoliu S, Ballesté B, Rivera M, Miquel M, Masnou H, Galeras JA, Giménez MD, Santos J, Cirera I, Morillas RM, Coll S, Solà R. Natural history of patients hospitalized for management of cirrhotic ascites. Clin Gastroenterol Hepatol. 2006;4:1385–94.CrossRefPubMed Planas R, Montoliu S, Ballesté B, Rivera M, Miquel M, Masnou H, Galeras JA, Giménez MD, Santos J, Cirera I, Morillas RM, Coll S, Solà R. Natural history of patients hospitalized for management of cirrhotic ascites. Clin Gastroenterol Hepatol. 2006;4:1385–94.CrossRefPubMed
34.
go back to reference Roberts LR, Kamath PS. Ascites and hepatorenal syndrome: pathophysiology and management. Mayo Clin Proc. 1996;71:874–81.CrossRefPubMed Roberts LR, Kamath PS. Ascites and hepatorenal syndrome: pathophysiology and management. Mayo Clin Proc. 1996;71:874–81.CrossRefPubMed
35.
go back to reference Starczewska MH, Mon W, Shirley P. Anaesthesia in patients with liver disease. Curr Opin Anaesthesiol. 2017;30:392–8.CrossRefPubMed Starczewska MH, Mon W, Shirley P. Anaesthesia in patients with liver disease. Curr Opin Anaesthesiol. 2017;30:392–8.CrossRefPubMed
36.
go back to reference Garg RK. Anesthetic considerations in patients with hepatic failure. Int Anesthesiol Clin. 2005;43:45–63.CrossRefPubMed Garg RK. Anesthetic considerations in patients with hepatic failure. Int Anesthesiol Clin. 2005;43:45–63.CrossRefPubMed
38.
go back to reference Cho HC, Jung HY, Sinn DH, et al. Mortality after surgery in patients with liver cirrhosis: comparison of Child-Turcotte-Pugh, MELD and MELDNa score. Eur J Gastroenterol Hepatol. 2011;23:51–9.CrossRefPubMed Cho HC, Jung HY, Sinn DH, et al. Mortality after surgery in patients with liver cirrhosis: comparison of Child-Turcotte-Pugh, MELD and MELDNa score. Eur J Gastroenterol Hepatol. 2011;23:51–9.CrossRefPubMed
39.
go back to reference Suman A, Carey WD. Assessing the risk of surgery in patients with liver disease. Cleve Clin J Med. 2006;73:398–404.CrossRefPubMed Suman A, Carey WD. Assessing the risk of surgery in patients with liver disease. Cleve Clin J Med. 2006;73:398–404.CrossRefPubMed
40.
go back to reference Teh SH, Nagorney DM, Stevens SR, et al. Risk factor for mortality after surgery in patient s with cirrhosis. Gastroenterology. 2007;132(4):1261.CrossRefPubMed Teh SH, Nagorney DM, Stevens SR, et al. Risk factor for mortality after surgery in patient s with cirrhosis. Gastroenterology. 2007;132(4):1261.CrossRefPubMed
41.
go back to reference Ghaferi AA, Mathur AK, Sonnenday CJ, Dimick JB. Adverse outcomes in patients with chronic liver disease undergoing colorectal surgery. Ann Surg. 2010;252:345–50.CrossRefPubMed Ghaferi AA, Mathur AK, Sonnenday CJ, Dimick JB. Adverse outcomes in patients with chronic liver disease undergoing colorectal surgery. Ann Surg. 2010;252:345–50.CrossRefPubMed
42.
go back to reference Lentschener C, Flaujac C, Ibrahim F, et al. Assessment of haemostasis in patients with cirrhosis: relevance of the ROTEM tests?: a prospective, crosssectional study. Eur J Anaesthesiol. 2016;33:126–33.CrossRefPubMed Lentschener C, Flaujac C, Ibrahim F, et al. Assessment of haemostasis in patients with cirrhosis: relevance of the ROTEM tests?: a prospective, crosssectional study. Eur J Anaesthesiol. 2016;33:126–33.CrossRefPubMed
43.
go back to reference Eschertzhuber S, Lindner KH, Hörmann C. Anästhesie für die Lebertransplantation (LTX). Anasthesiol Intensivmed Notfallmed Schmerzther. 2007;42(10):682–9.CrossRefPubMed Eschertzhuber S, Lindner KH, Hörmann C. Anästhesie für die Lebertransplantation (LTX). Anasthesiol Intensivmed Notfallmed Schmerzther. 2007;42(10):682–9.CrossRefPubMed
44.
go back to reference Salerno F, Navickis RJ, Wilkes MM. Albumin treatment regimen for type 1hepatorenal syndrome: a dose-response meta-analysis. BMC Gastroenterol. 2015;15:167.CrossRefPubMedPubMedCentral Salerno F, Navickis RJ, Wilkes MM. Albumin treatment regimen for type 1hepatorenal syndrome: a dose-response meta-analysis. BMC Gastroenterol. 2015;15:167.CrossRefPubMedPubMedCentral
45.
go back to reference Postlewait LM, et al. The relationship of blood transfusion with peri-operative and long-term outcomes after major hepatectomy for metastatic colorectal cancer: a multi-institutional study of 456 patients. HPB (Oxford). 2016;18:192–9.CrossRef Postlewait LM, et al. The relationship of blood transfusion with peri-operative and long-term outcomes after major hepatectomy for metastatic colorectal cancer: a multi-institutional study of 456 patients. HPB (Oxford). 2016;18:192–9.CrossRef
46.
go back to reference Hughes MJ, Ventham NT, Harrison EM, Wigmore SJ. Central venous pressure and liver resection: a systematic review and meta-analysis. HPB (Oxford). 2015;17(10):863–71.CrossRef Hughes MJ, Ventham NT, Harrison EM, Wigmore SJ. Central venous pressure and liver resection: a systematic review and meta-analysis. HPB (Oxford). 2015;17(10):863–71.CrossRef
47.
go back to reference Li Z, Sun YM, Wu FX, Yang LQ, Lu ZJ, Yu WF. Controlled low central venous pressure reduces blood loss transfusion requirements in hepatectomy. World J Gastroenterol. 2014;20(1):303–9.CrossRefPubMedPubMedCentral Li Z, Sun YM, Wu FX, Yang LQ, Lu ZJ, Yu WF. Controlled low central venous pressure reduces blood loss transfusion requirements in hepatectomy. World J Gastroenterol. 2014;20(1):303–9.CrossRefPubMedPubMedCentral
48.
go back to reference Correa-Gallego C, Berman A, Langdon-Embry L, et al. Renal function after low central pressure-assisted liver resection:assesmment of 2016. HPB (Oxford). 2015;17(3):258–64.CrossRef Correa-Gallego C, Berman A, Langdon-Embry L, et al. Renal function after low central pressure-assisted liver resection:assesmment of 2016. HPB (Oxford). 2015;17(3):258–64.CrossRef
49.
go back to reference Dünser M, Kwizera A. Perioperative fluid management. Eur Surg. 2017;49:41–8.CrossRef Dünser M, Kwizera A. Perioperative fluid management. Eur Surg. 2017;49:41–8.CrossRef
50.
go back to reference Mizota T, Yamamoto Y, Hamada M, Matsukawa S, Shimizu S, Kai S. Intraoperative oliguria predicts acute kidney injury after major abdominal surgery. Br J Anaesth. 2017;119(6):1127–34.CrossRefPubMed Mizota T, Yamamoto Y, Hamada M, Matsukawa S, Shimizu S, Kai S. Intraoperative oliguria predicts acute kidney injury after major abdominal surgery. Br J Anaesth. 2017;119(6):1127–34.CrossRefPubMed
Metadata
Title
Perioperative management of liver surgery—review on pathophysiology of liver disease and liver failure
Authors
Lukas Gasteiger
Stephan Eschertzhuber
Werner Tiefenthaler
Publication date
01-06-2018
Publisher
Springer Vienna
Published in
European Surgery / Issue 3/2018
Print ISSN: 1682-8631
Electronic ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-018-0522-4

Other articles of this Issue 3/2018

European Surgery 3/2018 Go to the issue