Left Hemihepatectomy with Liver Metastases

You review a 67-year-old man in the Preadmission Clinic (PAC) for a left hemihepatectomy via a roof-top incision for metastatic colon cancer. He underwent a right hemicolectomy four months ago for primary cancer resection. The procedure was complicated by an extended stay in hospital due to suboptimal pain management. Past medical history: - Hypertension - Lower limb peripheral neuropathy secondary to chemotherapy - Ex-smoker with 30 pack-year history Medications & allergies: - perindopril 5 mg daily - amitriptyline 25 mg nocte - Nil known allergies Observations in PAC: BP - 160/85 mmHg, HR - 75 bpm, SpO2 - 98% on room air, weight - 65 kg, height - 180 cm, BMI - 20 kg/m2 Liver function test results: Bilirubin 50 (3-17 umol/L), AST 40 (5-35 IU/L), ALT 38 (5-35 IU/L), ALP 560 (30-300 IU/L), GGT 110 (11-51 IU/L), Albumin 35 (35-50 g/L), INR 1.1 (0.8-1.2) All other blood results are normal.