title: Post-hepatectomy liver failure: Should we consider venous outflow?
abstract: BACKGROUND
  Post-hepatectomy liver failure (PHLF) is one of the most serious complications of liver resection and is associated with high morbidity and mortality rates.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  The present case support the hypothesis that outflow obstruction could lead symptoms similar to SFSS.
authors.affiliation: Department of General, Digestive and Endocrine Surgery, Hôpital Robert Debré, Centre Hospitalier Universitaire de Reims, Université de Reims Champagne-Ardenne, Reims, France. Electronic address: martin.lhuaire@etudiant.univ-reims.fr.
authors.forename: Martin
authors.initials: M
authors.lastname: Lhuaire
authors.affiliation: Department of General, Digestive and Endocrine Surgery, Hôpital Robert Debré, Centre Hospitalier Universitaire de Reims, Université de Reims Champagne-Ardenne, Reims, France.
authors.forename: Tullio
authors.initials: T
authors.lastname: Piardi
authors.affiliation: Department of Radiology, Hôpital Beaujon, Assistance Publique des Hôpitaux de Paris, Clichy, France.
authors.forename: Onorina
authors.initials: O
authors.lastname: Bruno
authors.affiliation: Department of Radiology, Hôpital Beaujon, Assistance Publique des Hôpitaux de Paris, Clichy, France.
authors.forename: Annie
authors.initials: A
authors.lastname: Sibert
authors.affiliation: Department of General, Digestive and Endocrine Surgery, Hôpital Robert Debré, Centre Hospitalier Universitaire de Reims, Université de Reims Champagne-Ardenne, Reims, France.
authors.forename: Reza
authors.initials: R
authors.lastname: Kianmanesh
authors.affiliation: Department of General, Digestive and Endocrine Surgery, Hôpital Robert Debré, Centre Hospitalier Universitaire de Reims, Université de Reims Champagne-Ardenne, Reims, France.
authors.forename: Daniele
authors.initials: D
authors.lastname: Sommacale
keywords: Hepatobiliary surgery; Interventional radiology; Post-hepatectomy liver failure; Small-for-size syndrome