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ID 117277
Author
Kaibori, Masaki Kansai Medical University
Matsui, Kosuke Kansai Medical University
Kubo, Shoji Osaka City University
Hasegawa, Kiyoshi The University of Tokyo
Keywords
liver cancer
perioperative management
review
surgery
Content Type
Journal Article
Description
Hepatocellular carcinoma is often accompanied by chronic hepatitis or cirrhosis. Preoperative evaluation of liver function and postoperative nutritional management are critical in patients with hepatocellular carcinoma who undergo liver surgery. Although the incidence of postoperative complications and death has declined in Japan over the last 10 years, postoperative complications have not been fully overcome. Therefore, surgical procedures and perioperative management must be improved. Accurate preoperative evaluations of liver function, nutrition, inflammation, and body skeletal muscle are required. Determination of the optimal surgical procedure should consider not only tumor characteristics but also the physical reserve of the patient. Nutritional management of chronic liver disorders, especially maintaining protein synthesis for postoperative protein/energy, is important. Prophylactic antibiotics are recommended for short-term use within 24 hours after surgery. Abdominal drainage is recommended for patients with cirrhosis who may develop large amounts of ascites, who are at risk of postoperative bleeding, or who may have bile leakage due to a large resection area. Postoperative exercise therapy may improve insulin resistance in patients with chronic liver damage. Implementation of an early/enhanced recovery after surgery program is recommended to reduce biological invasive responses and achieve early independence of physical activity and nutrition intake. We review the latest information on the perioperative management of patients undergoing liver resection for hepatocellular carcinoma.
Journal Title
Annals of Gastroenterological Surgery
ISSN
24750328
Publisher
The Japanese Society of Gastroenterological Surgery|Wiley
Volume
6
Issue
3
Start Page
344
End Page
354
Published Date
2021-12-15
Rights
This is an open access article under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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DOI (Published Version)
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language
eng
TextVersion
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departments
Medical Sciences