Bogner A, Reissfelder C, Striebel F, et al. - Researchers investigated intraoperative changes of hepatic macrohemodynamics and their correlation with ascites and posthepatectomy liver failure (PHLF) after major hepatectomy. In 67 consecutive patients with major hepatectomy (ie, resection of ≥ 3 liver segments), measurement of portal venous pressure (PVP), portal venous flow (PVF), and hepatic arterial flow (HAF) was done intraoperatively pre- and postresection. Controls comprised a group of 30 patients with minor hepatectomy. Major hepatectomy led to an increase in PVP by 26.9%, markedly lowering of HAF by 40.7%, and slight reduction in PVF by 13.4%. Little effect of minor resections on hepatic macrohemodynamics was evident. Overall findings suggest an independent value of intraoperative PVP kinetics as a predictive biomarker of PHLF after major hepatectomy. Data thereby highlight the relevance of assessing intraoperative dynamics rather than the pre- and postresection PVP values.