ArticleDer Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen2021
[Surgery in patients with liver cirrhosis].
Article in Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Is it safer to perform surgery before or after liver transplantation? A case-match study for colorectal and small-bowel surgery.Langenbeck's archives of surgery · 2025Article
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6 authors.
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Abstract
BACKGROUND AND
objectivePatients with liver cirrhosis who are in need of surgery show a high in-hospital mortality. This study examined the risk of postoperative morbidity and in-hospital mortality after operations on patients with liver cirrhosis. MATERIAL AND
methodsIn the time period from January 2010 to December 2017 a total of 321 patients with liver cirrhosis underwent general surgery in this department. Liver-specific scoring systems, such as the Child-Pugh score (CPS) and MELD score were retrospectively assessed and correlated with in-hospital mortality and perioperative morbidity using the Dindo-Clavien classification.
resultsOf the 321 patients (68% male) 21.2% underwent emergency surgery. These patients showed a mortality of 60%, which is significantly higher than in elective surgery (12%, p < 0.0001). Complex interventions showed a 41% mortality, minor interventions still 20.5% (p = 0.0001). The postoperative complication rate and mortality were significantly different sorted by CPS with 11.8%/6.3% in the CPS A category and 84%/73% in the CPS C category, respectively (p = 0.001). Statistically in-hospital mortality was increased by 20% for every point increase in the MELD score (odds ratio, OR 1.23, p = 0.0001). The presence of hepatic decompensation had the worst prognosis.
conclusionSurgical interventions in patients with liver cirrhosis are associated with a high complication rate and in-hospital mortality. The CPS and MELD scores can be used for objective risk assessment, while clinical examination for signs of hepatic decompensation is also important. Laboratory values, such as sodium and creatinine can assist the assessment.
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