Liver Cirrhosis and Biliary Surgery

Hm, Cryer; Da, Howard; Rn, Garrison

doi:10.1097/00007611-198502000-00005

Cited by 29 publications

(21 citation statements)

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“…In both elective and emergent cases, vasopressin (Intravenous Pitressin; Fujisawa USA Inc, Deerfield, IL) is an effective adjunct to handle problematic intraoperative bleeding. 20 This approach proved useful in temporarily controlling hemorrhage in 22 of our patients with cirrhosis.…”

Section: Discussionmentioning

confidence: 92%

“…In general, septic problems are most common with advanced cirrhosis and contribute heavily to the increased mortality. 20 In part, the increased infection rate may be explained by the impairment of Kupffer cell function that results in decreased intravascular clearance of enteric organisms. In addition, ascitic fluid may provide an ideal growth medium for bacterial contaminants released during cholecystectomy.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic cholecystectomy and cirrhosis: A case-control study of outcomes

et al. 2000

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The incidence of gallstone disease in patients with cirrhosis is greater than that in healthy patients. Previous surgical literature reported greater morbidity and mortality in patients with cirrhosis with both open and laparoscopic cholecystectomy (LC). We compared our recent experience with LC in patients with cirrhosis and controls. A retrospective review was performed using the search terms, ''cirrhosis'' and ''laparoscopic cholecystectomy.'' Forty-eight patients with cirrhosis were identified and randomly matched with healthy controls by age and sex.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Laparoscopic cholecystectomy and cirrhosis: A case-control study of outcomes

et al. 2000

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“…1). In a couple of series the mortality was 8-31%, even in Child's A or B groups of patients [7,8], the reasons for which are not readily apparent. Emergent procedures have a mortality rate 2-10 times higher [18][19][20] than that of elective surgery.…”

Section: Cholecystectomymentioning

confidence: 96%

“…Cryer et al [8] found that the preoperative risk factors of ascites, prolonged PT, and serum albumin !3.5 g/dl were associated with mortality rates of 50, 29 and 33% and morbidity of 50, 38 and 40%, respectively. Doberneck et al [9] retrospectively reviewed 102 cirrhotics who had elective or emergency surgery.…”

Section: Risk Assessment In Cirrhoticsmentioning

confidence: 99%

“…Mortality is uniformly high in patients with cirrhosis needing common bile duct (CBD) exploration, rates varying from 21 to 100% [7,8,23]. Factors determining the mortality are the degree of preexisting liver dysfunction, elective or emergent nature of surgery, the amount of intraoperative blood loss and the presence of renal failure.…”

Section: Common Bile Duct Surgerymentioning

confidence: 99%

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Risks of Intra-Abdominal Nonshunt Surgery in Cirrhotics

Gopalswamy

Mehta²,

Barde³

1998

Dig Dis

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We have reviewed the risks of various nonshunt intra-abdominal operations in cirrhotic patients. Most of these studies are retrospective reviews with limitations. Among various risk stratifications in cirrhosis, Child-Pugh classification is sufficiently informative. Elective surgery can be done safely in patients with Child’s A or B class. Operations in Child’s C patients and emergent surgery carry formidably high mortality. Limiting the extent of surgery, controlling ascites, correcting coagulation abnormality and malnutrition and aggressively treating infection, might reduce mortality. Laparoscopic cholecystectomy and endoscopic sphincterotomy in cirrhotics seem to be promising in reducing mortality and morbidity.

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