Department of Surgery, NHS Grampian, Foresterhill Health Campus, Ashgrove Road, AB252ZN Aberdeen, UK; Institute of Medical Sciences, Medical School, Foresterhill Health Campus, Ashgrove Road, AB252ZN Aberdeen, UK; Hépatica, Integrated Center of HPB Care, Elite Hospital, Agriculture Road, Alexandria, Egypt.
Department of Surgery, NHS Grampian, Foresterhill Health Campus, Ashgrove Road, AB252ZN Aberdeen, UK.
Hepatobiliary Pancreat Dis Int. 2023 Dec;22(6):554-569. doi: 10.1016/j.hbpd.2023.03.001. Epub 2023 Mar 16.
Post-hepatectomy liver failure (PHLF) is a leading cause of postoperative mortality after liver surgery. Due to its significant impact, it is imperative to understand the risk stratification and preventative strategies for PHLF. The main objective of this review is to highlight the role of these strategies in a timeline centered way around curative resection.
This review includes studies on both humans and animals, where they addressed PHLF. A literature search was conducted across the Cochrane Library, Embase, MEDLINE/PubMed, and Web of Knowledge electronic databases for English language studies published between July 1997 and June 2020. Studies presented in other languages were equally considered. The quality of included publications was assessed using Downs and Black's checklist. The results were presented in qualitative summaries owing to the lack of studies qualifying for quantitative analysis.
This systematic review with 245 studies, provides insight into the current prediction, prevention, diagnosis, and management options for PHLF. This review highlighted that liver volume manipulation is the most frequently studied preventive measure against PHLF in clinical practice, with modest improvement in the treatment strategies over the past decade.
Remnant liver volume manipulation is the most consistent preventive measure against PHLF.
肝切除术后肝功能衰竭（PHLF）是肝手术后术后死亡的主要原因。由于其影响重大，了解 PHLF 的风险分层和预防策略至关重要。本综述的主要目的是围绕根治性切除术，以时间为中心的方式强调这些策略的作用。
这篇综述包括了关于人类和动物的研究，其中涉及 PHLF。对 Cochrane 图书馆、Embase、MEDLINE/PubMed 和 Web of Knowledge 电子数据库进行了文献检索，检索了 1997 年 7 月至 2020 年 6 月期间发表的英语语言研究。同样考虑了其他语言的研究。使用 Downs 和 Black 的清单评估了纳入出版物的质量。由于缺乏符合定量分析条件的研究，结果以定性摘要的形式呈现。
这项纳入了 245 项研究的系统综述，深入了解了当前预测、预防、诊断和管理 PHLF 的选择。该综述强调，在临床实践中，肝脏体积操作为预防 PHLF 最常研究的预防措施，过去十年治疗策略有了适度的改善。
残余肝体积操作为预防 PHLF 最一致的预防措施。
