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Post hepatectomy liver failure – A comprehensive review of current concepts and controversies

机译:肝切除术后肝衰竭–当前概念和争议的全面回顾

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摘要

Post hepatectomy liver failure (PHLF) comprises of a conundrum of symptoms and signs following major hepatic resections. The pathophysiology essentially revolves around disruption of the normal hepatocyte regeneration and disturbed liver homeostasis. Prompt identification of the pre-operative predictors of PHLF in the form of biochemical parameters and imaging features are of paramount importance for any hepatic surgeon and forms the cornerstone of its management. Treatment revolves around a goal-directed resuscitation of the systemic organ failure. Auxiliary support systems such as liver dialysis devices and stem cell therapy are still under investigational trials for treatment of the same. Orthotopic liver transplantation (OLT) is the last resort in most cases not responding to other measures.
机译:肝切除术后肝衰竭(PHLF)包括主要肝切除术后的一系列症状和体征。病理生理学主要围绕正常肝细胞再生的破坏和肝稳态的破坏。以任何生化参数和影像学特征的形式及时识别PHLF的术前预测因素对于任何肝外科医生来说都是至关重要的,并构成了其管理的基石。治疗围绕目标器官器官衰竭的复苏进行。辅助支持系统,例如肝透析设备和干细胞疗法,仍在研究中,以对其进行治疗。在大多数情况下,原位肝移植(OLT)是对其他措施无反应的最后手段。

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