The principles of liver resection

Liver resection is now a well-established and routine treatment for malignant and some benign liver diseases. However, its associated mortality and morbidity should not be underestimated, especially as increasingly complex procedures in patients with increasing degrees of comorbidity are now being undertaken. A number of fundamental principles are important to consider, in terms of patient selection and perioperative care, as well as technical and anatomical tenets that, if adhered to, aid achievement of the best possible clinical outcomes for patients undergoing liver surgery. The introduction of modern technologies such as minimally invasive surgery and other techniques has made sound understanding of such principles all the more vital. This article will discuss many of these key underlying principles, illustrated with relevant surgical anatomy and how they pertain to modern techniques in liver resection.