ABSTRACT
The liver is involved in a wide variety of metabolic processes. Its roles include synthesis,
biotransformation, and detoxification. Derangements in any of these functions can occur
in the postoperative period as a result of the stress of surgery, the effects of anesthesia,
or the unmasking of underlying liver disease. Patients with pre-existing liver disease are
at increased risk for hepatic decompensation after surgery. The lack of controlled
studies makes the precise prediction of the risk of surgery difficult in patients with liver
disease. This chapter considers the evaluation of hepatic function to aid in the understand-
ing and prediction of surgical risk.
