The expansion of major liver surgery as a treatment option for various liver tumours has
presented new challenges to surgeons and physicians in terms of the assessment and
management of postoperative complications, particularly those involving hepatic insufficiency
and susceptibility to infection. Understanding of hepatic pathophysiology is important
for optimal perioperative care. Multiple factors contribute to increased mortality in
patients with underlying liver disease. But due to advances in surgery, anesthesia and improved
critical care management, there is progressive improvement in survival even in
complex situations. Patient selection with evaluation of the risk factors in various liver
conditions is needed. Reduction in mortality in patients with liver disease undergoing resection
depends on close attention to coagulation, intravascular volume, renal function,
electrolyte levels, cardiovascular status and nutrition. patient selection, appropriate monitoring,
and multidisciplinary postoperative management are the key elements in improved
survival among patients undergoing liver resections.