Outcomes of patients with cirrhosis undergoing non-hepatic surgery: risk assessment and management.
The reported mortality rates in patients with cirrhosis undergoing various non-transplant surgical procedures range from 8.3% to 25%. This wide range of mortality rates is related to severity of liver disease, type of surgery, demographics of patient population, expertise of the surgical, anesthesia and intensive care unit team and finally, reporting bias. In this article, we will review the pathophysiology, morbidity and mortality associated with non-hepatic surgery in patients with cirrhosis, and then recommend an algorithm for risk assessment and evidence based management strategy to optimize post-surgical outcomes.
Millwala
Farida
F
Hepatology Section, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Nguyen
Geoffrey C
GC
Thuluvath
Paul J
PJ
D000465:Algorithms; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology* / Q000517:prevention & control; D008103:Liver Cirrhosis / Q000150:complications*; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D018570:Risk Assessment; D012308:Risk Management; D013514:Surgical Procedures, Operative / Q000401:mortality*; D013812:Therapeutics
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