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in my notes under functional liver reserve its written more than 25 % resection can be done

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functional liver reserve hepatic resection minimum percentage criteria

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Your notes have it slightly reversed. Here is the corrected, authoritative version:

Functional Liver Reserve (FLR) - Correct Interpretation

The key concept is about the Future Liver Remnant (FLR) - what remains AFTER resection, not what is resected.
The correct statement is:
The FLR must be >25% for resection to be safe - meaning at least 25% of functional liver volume must be LEFT BEHIND.
This is the minimum that must REMAIN, not the minimum that can be taken out.

FLR Cutoffs by Liver Status (Fischer's Mastery of Surgery, 8th ed.)

Liver ConditionMinimum FLR Required
Normal, healthy liver>20% of preoperative volume
Steatotic liver / post-chemotherapy>30%
Significant cholestasis or cirrhosis>40%
So the "25%" figure in your notes is in the right ballpark for a normal liver (the textbook says >20%, with some studies quoting >25% as the threshold to prevent post-hepatectomy liver failure).

Why This Matters Clinically

  • Post-hepatectomy liver failure (PHLF) is the feared complication when FLR is inadequate
  • If the expected FLR is too small, Portal Vein Embolization (PVE) can be done preoperatively to induce hypertrophy of the future remnant - increasing FLR by ~12% on average before the actual resection
  • Assessment tools include: Child-Pugh score, MELD score, ICG (indocyanine green) clearance test, and 99mTc-mebrofenin hepatobiliary scintigraphy

Quick Memory Aid

Think of it as "what stays, not what goes":
  • Normal liver: leave >20-25% behind
  • Sick liver (cirrhotic/steatotic): leave >30-40% behind
  • The liver CAN regenerate, but only if the remnant is functional enough to sustain life while it does so
(Fischer's Mastery of Surgery, 8th ed., p. 4845 - "Future Liver Remnant: Goals and Cutoffs")
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