Anesthetic Management of Laparoscopic Liver Resection

Abstract

Due to recent methodological progress, laparoscopic liver resection has been widely accepted as a safe surgical approach in liver surgery. In the anesthetic management of this surgery, control of bleeding is the most important issue for a successful outcome. In this context, central venous pressure should be maintained at a low level. Airway pressure should be reduced and PEEP kept at a minimum level during resection. Elevation in pneumatoperitoneal pressure may be helpful to control bleeding, but the risk of gas embolism should be considered. Intraoperative oliguria（<0.3 mL/kg/hr）may be related to elevation of serum creatinine level（>0.3 mg/dL）postoperatively and should be carefully treated to maintain renal blood flow, especially after completion of the resection.