Figure 1.

Risk assessment and decision making in hepatic resection. Planning for a safe resection of a liver tumor with a large future liver remnant (FLR) reduces the risk for postoperative liver failure but increases the risk of recurrence. In contrast, planning for an oncologic radical surgery requires a safety margin. Extending the safety margin (e.g., 10 vs. 1 mm) in case of a centrally located tumor leads to a substantially extended resection leaving a rather small future liver remnant behind, which increases the risk of postoperative liver failure. Preexisting liver disease such as steatosis increases the risk for postoperative liver failure and might therefore call for a smaller safety margin compared to livers without preexisting diseases.