Skip to main content
Top
Published in: Journal of Gastrointestinal Surgery 3/2019

01-03-2019 | Evidence-Based Current Surgical Practice

Non-Hepatic Abdominal Surgery in Patients with Cirrhotic Liver Disease

Authors: Laura Hickman, Lauren Tanner, John Christein, Selwyn Vickers

Published in: Journal of Gastrointestinal Surgery | Issue 3/2019

Login to get access

Abstract

Cirrhotic liver disease is an important cause of peri-operative morbidity and mortality in general surgical patients. Early recognition and optimization of liver dysfunction is imperative before any elective surgery. Patients with MELD <12 or classified as Child A have a higher morbidity and mortality than matched controls without liver dysfunction, but are generally safe for elective procedures with appropriate patient education. Patients with MELD >20 or classified as Child C should undergo transplantation before any elective procedure given mortality exceeds 40%. Laparoscopic procedures are feasible and safe in cirrhotic patients.
Literature
4.
go back to reference Friedman LS. Surgery in the patient with liver disease. Trans Am Clin Climatol Assoc. 2010;121:192–204; discussion 5.PubMedPubMedCentral Friedman LS. Surgery in the patient with liver disease. Trans Am Clin Climatol Assoc. 2010;121:192–204; discussion 5.PubMedPubMedCentral
7.
go back to reference Northup PG, Wanamaker RC, Lee VD, Adams RB, Berg CL. Model for End-Stage Liver Disease (MELD) predicts nontransplant surgical mortality in patients with cirrhosis. Ann Surg. 2005;242(2):244–51.CrossRefPubMedPubMedCentral Northup PG, Wanamaker RC, Lee VD, Adams RB, Berg CL. Model for End-Stage Liver Disease (MELD) predicts nontransplant surgical mortality in patients with cirrhosis. Ann Surg. 2005;242(2):244–51.CrossRefPubMedPubMedCentral
12.
go back to reference Garrison RN, Cryer HM, Howard DA, Polk HC, Jr. Clarification of risk factors for abdominal operations in patients with hepatic cirrhosis. Ann Surg. 1984;199(6):648–55.CrossRefPubMedPubMedCentral Garrison RN, Cryer HM, Howard DA, Polk HC, Jr. Clarification of risk factors for abdominal operations in patients with hepatic cirrhosis. Ann Surg. 1984;199(6):648–55.CrossRefPubMedPubMedCentral
13.
go back to reference Mansour A, Watson W, Shayani V, Pickleman J. Abdominal operations in patients with cirrhosis: still a major surgical challenge. Surgery. 1997;122(4):730–5; discussion 5-6.CrossRefPubMed Mansour A, Watson W, Shayani V, Pickleman J. Abdominal operations in patients with cirrhosis: still a major surgical challenge. Surgery. 1997;122(4):730–5; discussion 5-6.CrossRefPubMed
28.
go back to reference Ziser A, Plevak DJ, Wiesner RH, Rakela J, Offord KP, Brown DL. Morbidity and mortality in cirrhotic patients undergoing anesthesia and surgery. Anesthesiology. 1999;90(1):42–53.CrossRefPubMed Ziser A, Plevak DJ, Wiesner RH, Rakela J, Offord KP, Brown DL. Morbidity and mortality in cirrhotic patients undergoing anesthesia and surgery. Anesthesiology. 1999;90(1):42–53.CrossRefPubMed
37.
go back to reference Ji W, Li LT, Wang ZM, Quan ZF, Chen XR, Li JS. A randomized controlled trial of laparoscopic versus open cholecystectomy in patients with cirrhotic portal hypertension. World J Gastroenterol. 2005;11(16):2513–7.CrossRefPubMedPubMedCentral Ji W, Li LT, Wang ZM, Quan ZF, Chen XR, Li JS. A randomized controlled trial of laparoscopic versus open cholecystectomy in patients with cirrhotic portal hypertension. World J Gastroenterol. 2005;11(16):2513–7.CrossRefPubMedPubMedCentral
39.
go back to reference Metcalf AM, Dozois RR, Wolff BG, Beart RW, Jr. The surgical risk of colectomy in patients with cirrhosis. Dis Colon Rectum. 1987;30(7):529–31.CrossRefPubMed Metcalf AM, Dozois RR, Wolff BG, Beart RW, Jr. The surgical risk of colectomy in patients with cirrhosis. Dis Colon Rectum. 1987;30(7):529–31.CrossRefPubMed
40.
go back to reference Tsugawa K, Koyanagi N, Hashizume M, Tomikawa M, Ayukawa K, Akahoshi K et al. A comparison of an open and laparoscopic appendectomy for patients with liver cirrhosis. Surg Laparosc Endosc Percutan Tech. 2001;11(3):189–94.CrossRefPubMed Tsugawa K, Koyanagi N, Hashizume M, Tomikawa M, Ayukawa K, Akahoshi K et al. A comparison of an open and laparoscopic appendectomy for patients with liver cirrhosis. Surg Laparosc Endosc Percutan Tech. 2001;11(3):189–94.CrossRefPubMed
43.
go back to reference Bessa SS, Abdel-Razek AH, Sharaan MA, Bassiouni AE, El-Khishen MA, El-Kayal el SA. Laparoscopic cholecystectomy in cirrhotics: a prospective randomized study comparing the conventional diathermy and the harmonic scalpel for gallbladder dissection. J Laparoendosc Adv Surg Tech A. 2011;21(1):1–5. https://doi.org/10.1089/lap.2010.0255.CrossRefPubMed Bessa SS, Abdel-Razek AH, Sharaan MA, Bassiouni AE, El-Khishen MA, El-Kayal el SA. Laparoscopic cholecystectomy in cirrhotics: a prospective randomized study comparing the conventional diathermy and the harmonic scalpel for gallbladder dissection. J Laparoendosc Adv Surg Tech A. 2011;21(1):1–5. https://​doi.​org/​10.​1089/​lap.​2010.​0255.CrossRefPubMed
Metadata
Title
Non-Hepatic Abdominal Surgery in Patients with Cirrhotic Liver Disease
Authors
Laura Hickman
Lauren Tanner
John Christein
Selwyn Vickers
Publication date
01-03-2019
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 3/2019
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-018-3991-7

Other articles of this Issue 3/2019

Journal of Gastrointestinal Surgery 3/2019 Go to the issue