Anesthetic considerations during liver surgery

Recent advances in surgical and anesthetic management have reduced the operative risk of major hepatectomies significantly. Understanding the underlying pathological conditions of liver disease and the physiology of vascular exclusion and surgical resection has significantly contributed to goal-oriented anesthetic management. The progressive improvements in survival despite the increasing complexity of the surgery are a testament to advances in both surgery and anesthesia. The key elements include careful patient selection, appropriate monitoring, and mechanical and pharmacologic protection of the liver and other vital organs.