Surgery in the Patient with Liver Disease

Model for End-stage Liver Disease

“…87 The effect of the surgical procedure, blood loss, hypoxemia due to ascites and/or hydrothorax, and anesthetic agents all make a diseased liver prone to further deterioration with a potential risk for precipitating liver failure. 88 Severity of liver disease predicting outcome after surgery has been known for years. Earlier, the risk used to be gauged using the CTP stage with 10%, 30%, and 82% postoperative mortality amongst patients with CTP stages A, B, and C respectively.…”

Isolated traumatic brain injury in patients with cirrhosis: do different treatment paradigms result in increased mortality?

“…While evidence exists for increased morbidity and mortality in cirrhotic patients following elective surgery (22)(23)(24), caution must be taken to extent these conclusions to interventions following TBI as conclusive data for these assumptions is lacking. incomplete charting from practitioners.…”

Liver Disease and Perioperative Risk

“…■ Ask about: alcohol use, blood transfusions, IV drug use, and sexual history ■ Look for: jaundice, spider telangiectasias, palmar erythema, gynecomastia, testicular atrophy, splenomegaly, encephalopathy, ascites, and peripheral edema ■ Checking liver biochemical tests for screening purposes in asymptomatic patients is generally not recommended [ 2 ] …”