Variables such as severity of underlying cirrhosis, degree of debility before surgery, associated
co-morbid diseases and operative complexity appear to have a significant influence on
the rapidity at which patients progress through their early postoperative recovery phase.
Attributed to regenerating capacity of the liver, most of the major liver resections are well tolerated
and seldom patients have significant biochemical abnormalities. Patients with compensated
liver cirrhosis and its complications are more prone for intraoperative blood loss causing
deterioration of organ functions and loss of reserve capacity to withstand even minor stress
causing life-threatening complications. The disturbances in cardio-respiratory function
should be carefully monitored in high Dependency unit. The complications are more in elderly
patients. The condition of older patients can change rapidly and therapy may need to be adjusted
every few hours if optimum cardio-respiratory function is to be maintained.
84 Hepatic Surgery
• Planning of intensive monitoring for high risk patients with associated co-morbidities
should be done during surgery and in postoperative wards
• Diagnose and treat complications quickly
• Institute invasive monitoring and elective ventilation when required
• Continue postoperative care to increase the rate of recovery.