Nutritional Support After Surgery of the Liver

Abstract

Liver resection remains the only curative treatment for hepatic malignancies. Many progresses have been recently done in the field of chemotherapy that, in association with surgery, could guarantee the best survival for patients with liver malignancies including primitive cancer (hepatocellular carcinoma, cholangiocarcinoma) and metastatic cancer (colorectal liver metastasis, breast cancer). The main concept of resectability in liver surgery is associated to the concept of leaving a sufficient quote of liver parenchyma to guarantee a sufficient liver function which is mandatory to reduce the risk of postoperative liver failure. Recently, several improvements in the perioperative management of surgical patient have been introduced. For example, prediction of future remnant liver could be calculated with 3D reconstruction software, as well as quality of liver function with the ICG test. Minimally invasive surgery (robotic and laparoscopic) has also contributed to minimize the surgical trauma. Furthermore, adhesion to the ERAS (enhanced recovery after surgery) protocols has contributed to reduce postoperative in hospital stay.