Intra-abdominal surgery in patients with advanced cirrhosis.
Between 1971 and 1984, intra-abdominal surgical procedures were required in 51 patients with cirrhosis who had advanced liver dysfunction and/or ascites. These included the following types of surgery: gastric, 17 patients; small bowel, two patients; colon, five patients; hepatic, nine patients; and pancreas, nine patients. Twelve patients also underwent exploratory celiotomy for an acute condition of the abdomen (six patients) and jaundice (six patients). Patients fell into two groups: (1) those with prothrombin time (PT) greater than 2.5 s over control (24 patients), and (2) those with PT within 2.5 s of control (27 patients). The 30-day mortality rate was 34 (67%) of 51 patients. Nineteen (83%) of 23 patients who had ascites died. Twenty-two (91%) of 24 patients with elevated PT greater than 2.5 s of control died. Twenty-five (86%) of 29 patients who underwent surgery under emergency conditions died. Intraabdominal surgery in decompensated patients with cirrhosis must be undertaken with great caution.
D000005:Abdomen / Q000601:surgery*; D000006:Abdomen, Acute / Q000601:surgery; D000328:Adult; D000368:Aged; D001201:Ascites / Q000150:complications; D003106:Colon / Q000601:surgery; D004630:Emergencies; D006801:Humans; D007421:Intestine, Small / Q000601:surgery; D007565:Jaundice / Q000601:surgery; D008099:Liver / Q000601:surgery; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery; D011379:Prognosis; D011517:Prothrombin Time; D012189:Retrospective Studies; D013270:Stomach / Q000601:surgery