{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:57:29Z","timestamp":1792684649333,"version":"4.5.0"},"reference-count":143,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2023,8,12]],"date-time":"2023-08-12T00:00:00Z","timestamp":1691798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Posthepatectomy liver failure (PHLF) contributes significantly to morbidity and mortality after liver surgery. Standardized assessment of preoperative liver function is crucial to identify patients at risk. These European consensus guidelines provide guidance for preoperative patient assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A modified Delphi approach was used to achieve consensus. The expert panel consisted of hepatobiliary surgeons, radiologists, nuclear medicine specialists, and hepatologists. The guideline process was supervised by a methodologist and reviewed by a patient representative. A systematic literature search was performed in PubMed\/MEDLINE, the Cochrane library, and the WHO International Clinical Trials Registry. Evidence assessment and statement development followed Scottish Intercollegiate Guidelines Network methodology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Based on 271 publications covering 4 key areas, 21 statements (at least 85 per cent agreement) were produced (median level of evidence 2\u2212 to 2+). Only a few systematic reviews (2++) and one RCT (1+) were identified. Preoperative liver function assessment should be considered before complex resections, and in patients with suspected or known underlying liver disease, or chemotherapy-associated or drug-induced liver injury. Clinical assessment and blood-based scores reflecting liver function or portal hypertension (for example albumin\/bilirubin, platelet count) aid in identifying risk of PHLF. Volumetry of the future liver remnant represents the foundation for assessment, and can be combined with indocyanine green clearance or LiMAx\u00ae according to local expertise and availability. Functional MRI and liver scintigraphy are alternatives, combining FLR volume and function in one examination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These guidelines reflect established methods to assess preoperative liver function and PHLF risk, and have uncovered evidence gaps of interest for future research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjs\/znad233","type":"journal-article","created":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T02:55:38Z","timestamp":1689821738000},"page":"1331-1347","source":"Crossref","is-referenced-by-count":95,"title":["E-AHPBA\u2013ESSO\u2013ESSR Innsbruck consensus guidelines for preoperative liver function assessment before hepatectomy"],"prefix":"10.1093","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2707-6307","authenticated-orcid":false,"given":"Florian","family":"Primavesi","sequence":"first","affiliation":[{"name":"Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck , Innsbruck , Austria"},{"name":"Department of General, Visceral and Vascular Surgery, Centre for Hepatobiliary Surgery , V\u00f6cklabruck , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1479-6129","authenticated-orcid":false,"given":"Manuel","family":"Maglione","sequence":"additional","affiliation":[{"name":"Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck , Innsbruck , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8651-5982","authenticated-orcid":false,"given":"Federica","family":"Cipriani","sequence":"additional","affiliation":[{"name":"Hepatobiliary Surgery Division, San Raffaele Scientific Institute , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timm","family":"Denecke","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Medical Centre Leipzig , Leipzig , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7330-3876","authenticated-orcid":false,"given":"Christian E","family":"Oberkofler","sequence":"additional","affiliation":[{"name":"Swiss Hepatopancreatobiliary Transplant Centre, Department of Surgery, University Hospital Z\u00fcrich , Z\u00fcrich , Switzerland"},{"name":"Viv\u00e9vis AG\u2014Visceral, Tumour and Robotic Surgery, Clinic Hirslanden Z\u00fcrich , Z\u00fcrich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Starlinger","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, Mayo Clinic , Rochester, Minnesota , USA"},{"name":"Centre of Physiology and Pharmacology, Medical University of Vienna , Vienna , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2375-1141","authenticated-orcid":false,"given":"Bobby V M","family":"Dasari","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary\u2013pancreatic and Liver Transplantation Surgery, University of Birmingham , Birmingham , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Heil","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, Transplant and Thoracic Surgery, Goethe University Frankfurt, University Hospital , Frankfurt , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6965-3697","authenticated-orcid":false,"given":"Olivia","family":"Sgarbura","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Cancer Institute of Montpellier, University of Montpellier , Montpellier , France"},{"name":"IRCM, Institut de Recherche en Canc\u00e9rologie de Montpellier, INSERM U1194, Universit\u00e9 de Montpellier, Institut R\u00e9gional du Cancer de Montpellier , Montpellier , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7594-4354","authenticated-orcid":false,"given":"Kjetil","family":"S\u00f8reide","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Hepatopancreatobiliary Unit, Stavanger University Hospital , Stavanger , Norway"},{"name":"Department of Clinical Medicine, University of Bergen , Bergen , 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Radiology, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health , Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Henninger","sequence":"additional","affiliation":[{"name":"Department of Radiology, Medical University of Innsbruck , Innsbruck , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia J","family":"Hessheimer","sequence":"additional","affiliation":[{"name":"General and Digestive Surgery Service, Hospital Universitario La Paz, IdiPAZ, CIBERehd , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2397-4599","authenticated-orcid":false,"given":"Micka\u00ebl","family":"Lesurtel","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Beaujon Hospital, Assistance 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