title: Surgical clearance for the patient with chronic liver disease.
abstract: Patients with chronic liver disease face greater risk of perioperative morbidity and mortality, with the greatest risk among patients with cirrhosis. Both the Child-Pugh score and the Model for End-Stage Liver Disease have been evaluated as predictors of postoperative mortality. Other comorbidities, age, and American Society of Anesthesiologists physical status classification are also important predictors of these outcomes. In patients with liver disease, elective surgeries should be delayed to allow complete evaluation of the severity of liver disease, including the role of transplantation in the event of hepatic decompensation postoperatively.
authors.affiliation: Division of Gastroenterology, Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC 27715, USA. andrew.muir@duke.edu
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Muir
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000601:surgery; D002908:Chronic Disease; D003324:Coronary Artery Disease / Q000150:complications / Q000601:surgery; D003657:Decision Making; D058625:End Stage Liver Disease / Q000601:surgery; D015390:Gastric Bypass; D006498:Hepatectomy; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation; D009765:Obesity / Q000150:complications / Q000601:surgery*; D019990:Perioperative Care; D012017:Referral and Consultation; D012720:Severity of Illness Index