Expert consensus on perioperative assessment of hepatic reserve function (2025 edition)

Hepatectomy is an important treatment for hepatobiliary surgical diseases. However, diseases such as hepatocellular carcinoma are often complicated by parenchymal liver injury, resulting in varied degrees of impairment of liver reserve function. Factors such as hepatocyte loss caused by hepatectomy, hepatic ischemia‑reperfusion injury, abnormal blood flow in the residual liver, and surgical trauma response can induce postoperative liver dysfunction, which has become an important cause of perioperative death in patients. Therefore, accurate preoperative assessment of hepatic reserve function is crucial for selecting the surgical method of hepatectomy, formulating perioperative management plans, reducing the risk of postoperative liver failure, and promoting patients′ postoperative rehabilitation. The Expert consensus on preoperative assessment of liver reserve function for hepatectomy (2011 edition) has provided important references for the clinical evaluation of patients undergoing hepatectomy and been widely used in clinical practice. With the ongoing refinement of precision hepatobiliary surgical paradigms and the rapid evolution of precision hepatectomy techniques, an updated consensus is urgently warranted to further guide and stan-dardize clinical practice in hepatic surgery. Society for Hepato‑pancreato‑biliary Surgery of Chinese Research Hospital Association, Editorial Board of Chinese Journal of Digestive Surgery have organized relevant experts to conduct in‑depth discussions and formulate Expert consensus on perioperative assessment of liver reserve function (2025 edition). Its main contents include integrating liver functional test indicators, comprehensive liver scoring systems, quantitative liver function tests, imaging tech-nologies, and three‑dimensional volumetry to establish a multi-modal assessment system for evalua-ting liver reserve function. Based on this system, the decision‑making algorithm for determining the safe resection limits in hepatectomy is further refined and updated.