Chapter 55
- Anesthesia and the Hepatobiliary System
- Christopher J. O'Connor
- David M. Rothenberg
- Kenneth J. Tuman
The liver is the largest organ in the body and plays a critical
role in the homeostasis of many physiologic systems, including nutrient and drug
metabolism, synthesis of plasma proteins and critical hemostatic factors, and detoxification
and elimination of many endogenous and exogenous substances.[1]
Acute or chronic liver dysfunction can impair the response to anesthesia and surgery
in several critical ways, whereas certain anesthetics and hemodynamic disturbances
can induce unique and serious alternations in postoperative hepatic function.
This chapter will review the anesthetic implications of acute
and chronic liver disease, the impact of anesthetics on hepatic function, evaluation
of perioperative changes in liver function test results and hepatobiliary function,
and periprocedural considerations for some selected surgical procedures involving
the liver and gallbladder.
