A partial hepatectomy may need to be done to remove a cancer or to control bleeding after trauma. Removal of too much liver may be followed by complications and death. The ratio of volumes for the remaining liver to the original volume can help to decide if a planned resection is safe or hazardous.


Patient selection: partial hepatectomy in a patient with the uninvolved liver normal


Parameters from imaging studies:

(1) total liver volume (TLV) in mL prior to resection

(2) residual liver volume (RLV) in mL


RLV to TLV ratio =

= (residual liver volume) / (total liver volume)



• A resection that results in a ratio >= 25% can be done safely.

• A resection that results in a ratio 20-24% is reported by some authors as being relatively safe if done by experienced surgeons.

• A resection with a ratio < 20% is associated with a high risk of postoperative complications including hepatic insufficiency.


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