Hepatic Metastases for Right Hepatectomy

Liver secondaries are common indication for hepatic resection surgeries. These surgeries result in significant morbidity due to blood loss, hepatic dysfunction and fluid shifts. A comprehensive perioperative management is required for successful conduct of surgery. Preoperative goals include assessment of underlying comorbidities, hepatic function, future remnant liver and portal vein embolization, if required. Intraoperative anaesthetic management consists of titration of anaesthetic drugs, close monitoring of vitals including invasive arterial and central venous pressure monitoring, blood transfusion management, minimizing blood loss and optimal fluid therapy. Postoperative period may result in hepatic dysfunction and coagulopathy. Pain control is of utmost importance and plan should be formulated in preoperative period for the same.