Post-hepatectomy liver failure: Should we consider venous outflow?

INTRODUCTION: Post-hepatectomy liver failure (PHLF) is one of the most serious complications of liver resection and is associated with high morbidity and mortality rates. PRESENTATION OF CASE: We report a case of PHLF involving clinical presentation of posthepatectomy-related ‘small-for-size’ syndrome (SFSS) secondary to obstructed venous outflow in the liver remnant, following extended right hepatectomy. DISCUSSION: PHLF is similar to SFSS in liver transplantation (LT) in terms of pathogenesis, clinical presentation and outcomes. Although inflow hypertension is clearly implicated in the pathogenesis of SFSS some authors have suggested that outflow obstruction is a potential pathogenic factor. CONCLUSION: The present case support the hypothesis that outflow obstruction could lead symptoms similar to SFSS.