Inguinal Hernia Repair in Patients with Cirrhosis is not Associated with Increased Risk of Complications and Recurrence

Although inguinal hernia in patients with liver cirrhosis (LC) is not uncommon, literature comparing operative complications and long-term recurrence rate after inguinal hernia repair in LC patients and non-LC patients is limited.

A total of 780 eligible patients including 129 (16.5%) patients with LC underwent inguinal hernia repair with the standard McVay procedure by a single surgeon over a 10-year period. Patients were prospectively registered and clinical data were analyzed retrospectively.

In the LC group, 45 patients were of Child-Turcotte-Pugh (CTP) class A (34.9%), 66 were class B (51.1%), and 18 were class C (14.0%). Eighty-one patients with LC (62.8%) had ascites at the time of operation. Postoperative complications occurred in 14 LC patients (10.9%). Complication rate was unrelated to CTP class (A:B:C = 11.1%:9.1%:16.7%; P = 0.69) and was not higher than among non-LC patients (6.8%; P = 0.11). Two LC patients (1.6%) of CTP class C died postoperatively from hepatic failure. In LC group patients, median follow-up was 22.9 months and recurrence developed in three (2.3%). Cumulative recurrence rates were not significantly different between the LC and non-LC patient groups (P = 0.87). The cumulative rate of contralateral side hernia development was also similar between the two groups (P = 0.63).

Our results indicate that the incidence of postoperative complications and long-term recurrence after inguinal hernia repair in LC patients does not differ from that in non-LC patients. Elective repair of symptomatic inguinal hernia in patients with cirrhosis should be advocated.