Assessing the Non-tumorous Liver

Implications for Patient Management and Surgical Therapy

Pallavi Pandey, Ankur Pandey, Mary Dillhoff, Carl Schmidt, Ihab R Kamel, Timothy M. Pawlik

Research output: Contribution to journalArticle

Abstract

Introduction: Hepatic resection is performed for various benign and malignant liver tumors. Over the last several decades, there have been improvements in the surgical technique and postoperative care of patients undergoing liver surgery. Despite this, liver failure following an extended hepatic resection remains a critical potential postoperative complication. Patients with underlying parenchymal liver diseases are at particular risk of liver failure due to impaired liver regeneration with an associated mortality risk as high as 60 to 90%. In addition, live donor liver transplantation requires a thorough presurgical assessment of the donor liver to minimize the risk of postoperative complications. Results and Conclusion: Recently, cross-sectional imaging assessment of diffuse liver diseases has gained momentum due to its ability to provide both anatomical and functional assessments of normal and abnormal tissues. Various imaging techniques are being employed to assess diffuse liver diseases including magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound (US). MRI has the ability to detect abnormal intracellular and molecular processes and tissue architecture. CT has a high spatial resolution, while US provides real-time imaging, is inexpensive, and readily available. We herein review current state-of-the-art techniques to assess the underlying non-tumorous liver. Specifically, we summarize current approaches to evaluating diffuse liver diseases including fatty liver alcoholic or non-alcoholic (NAFLD, AFLD), hepatic fibrosis (HF), and iron deposition (ID) with a focus on advanced imaging techniques for non-invasive assessment along with their implications for patient management. In addition, the role of and techniques to assess hepatic volume in hepatic surgery are discussed.

Original languageEnglish (US)
Pages (from-to)1-17
Number of pages17
JournalJournal of Gastrointestinal Surgery
DOIs
StateAccepted/In press - Sep 18 2017

Fingerprint

Liver
Liver Diseases
Therapeutics
Liver Failure
Alcoholic Fatty Liver
Tomography
Magnetic Resonance Imaging
Tissue Donors
Liver Regeneration
Postoperative Care
Liver Transplantation
Fibrosis
Iron
Mortality
Neoplasms

Keywords

  • Fibrosis
  • Imaging
  • Liver
  • Non-tumorous
  • Steatosis

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Assessing the Non-tumorous Liver : Implications for Patient Management and Surgical Therapy. / Pandey, Pallavi; Pandey, Ankur; Dillhoff, Mary; Schmidt, Carl; Kamel, Ihab R; Pawlik, Timothy M.

In: Journal of Gastrointestinal Surgery, 18.09.2017, p. 1-17.

Research output: Contribution to journalArticle

Pandey, Pallavi ; Pandey, Ankur ; Dillhoff, Mary ; Schmidt, Carl ; Kamel, Ihab R ; Pawlik, Timothy M. / Assessing the Non-tumorous Liver : Implications for Patient Management and Surgical Therapy. In: Journal of Gastrointestinal Surgery. 2017 ; pp. 1-17.
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