The reasonability of routine volumetry prior to liver transplantation is unquestionable. However, there is a lack of clear recommendations for this procedure in the cohort of patients with planned liver resection. Objectives:
Analysis of the results of own experience and recent literature data on precise determination of optimal approach for volumetry implementation for liver resection. The volume of future liver remnant is a critical factor of hepato-biliary surgery as it represents potential risk factors of acute liver failure (ALF) in postoperative period. Such a questions like safe minimal parenchyma volume of future liver remnant (FLR) and selection of the modality of its volume calculation remain to be unclear.
Results: The median of total liver volume was 1784.1±72, 1763.3±94 and 1799.9±81 mm3 while used Philips Workstation, Onis 2.5 and Varian Eclipse, respectively (р = 0.54). The median of FLR volume was 375.4±115, 368.7±111 and 397.9±110 mm3 with mentioned above programs, respectively, (р = 0.73). We emphasize that preoperative calculation of FLR volume, precise examination of variant vascular and biliary liver anatomy are critical for reduction of surgical complications rate, especially when extensive resections are planned.
Conclusions: Analysis of own results and literature data demonstrate importance of carried out studies and indicate reliable correlation between manual and semi-automatic methods of volumetric measurements of liver and its separate segments/sections. We demonstrate that volumetry of liver and its separate anatomic structures in case of “major” resections is a necessary stage in preoperative examination in terms of calculation of minimally permissible tissue volume in such patients. MRI and CT images are equivalent, self-sufficient and high informative methods for liver volumetry implementation. Analysis of radiological images demonstrates that manual volumetry with independent software application allows prediction of the future volume of FLR and ALF risks in postoperative period.