The surgical risk of colectomy in patients with cirrhosis

Metcalf, Amanda M.; Dozois, Roger R.; Wolff, Bruce G.; Beart, Robert W.

doi:10.1007/bf02554783

Cited by 72 publications

(44 citation statements)

References 7 publications

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“…Not surprising is that the length of hospital stay (up to 68%) and total hospital charges (up to 45%) were also increased compared to noncirrhotic patients [8]. Indeed, all authors focusing on this topic reported on an increased mortality rate in cirrhotic patients, which varied from 4 to 54% [7,8,13,14,15,16,17,18,19,20,21]. Csikesz et al [8] found that (dependent on the type of surgery: cholecystectomy, colectomy, coronary artery bypass grafting, abdominal aortic aneurysm repair) cirrhotic patients had a 3.4- to 8-fold increased risk of death, whereas those with cirrhosis along with portal hypertension experienced a 7.8- to 22.7-fold increased risk of death.…”

Section: Discussionmentioning

confidence: 99%

Safety of Pancreatic Surgery in Patients with Simultaneous Liver Cirrhosis: A Single Center Experience

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Safety of Pancreatic Surgery in Patients with Simultaneous Liver Cirrhosis: A Single Center Experience

et al. 2011

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“…Cirrhosis and PHT are increasingly frequent conditions and are acknowledged to be associated with increased surgical risk after abdominal operations (10). Many investigators have observed that patients with cirrhosis and PHT tend to be more likely to have grave postoperative complications after cholecystectomy, frequently leading to their eventual death (11,12). One study showed that open cholecystectomy for cirrhotic patients had an 11-fold risk of 30-day mortality compared to open cholecystectomy for noncirrhotic patients (13).…”

Section: Discussionmentioning

confidence: 99%

Cholecystolithotomy Combined Armillarisin A versus Cholecystectomy in Cirrhotic Portal Hypertension Patients with Symptomatic Cholelithiasis

Yang¹,

Li²,

Zong³

et al. 2017

chr

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Scop: De a evalua în spitalul autorilor dacă la pacienţii cu ciroză şi hipertensiune portală cu colelitiază simptomatică tratamentul prin colecistotomie combinată cu Armillarisin A ar aduce noi beneficii. Metode: Şaizeci şi unu de pacienţi cu ciroză şi hipertensiune portală cu boală litiazică veziculară simptomatică trataţi pentru colelitiază fie prin colecistotomie combinată cu Armillarisin A (grupul A), fie prin colecistectomie (grupul B), în perioada februarie 2007 -martie 2011, au fost analizaţi retrospectiv. Aceşti pacienţi erau concomitent trataţi pentru varice esofagice. Au fost analizate datele operatorii relevante, modificările apărute la nivelul analizelor de sânge, complicaţiile postoperatorii şi simptomatologia. Rezultate: Nu au existat diferenţe semnificative între grupul A şi grupul B în ceea ce priveşte durata operaţiei, pierderea intraoperatorie de sânge, timpul până la reluarea dietei postoperator şi durata spitalizării (P > 0.05). Profilul biochimic al funcţiei hepatice şi scorul Child-Pugh la 2 săptămâni şi o lună după operaţie au fost ambele semnificativ mai mici în grupul A comparativ cu grupul B (ALT, 0.008, 0.011; AST, 0.006, 0.003; scorul Child-Pugh, 0.010, respectiv 0.016). Totuşi, la 6 luni postoperator, modificările nu au fost semnificative statistic (P > 0.05). Cu excepţia recurenţei litiazei biliare şi a infecţiilor de plagă, incidentele sau complicaţiile postoperatorii incluzând fistule biliare, insuficienţă hepatică şi infecţia subfrenică au prezentat diferenţe semnificative între cele două

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“…Other authors have published studies evaluating the healing of peptic ulcers in patients with hepatic cirrhosis 20 , but there are few studies on hepatic cirrhosis and anastomosis healing [21][22][23] . Patients with cirrhosis may require colonic anastomosis, which causes concern on the part of the surgeon 22 . This study evaluated the influence of hepatic cirrhosis on the healing of colonic anastomosis.…”

Section: Introductionmentioning

confidence: 99%

Liver cirrhosis on the colonic anastomotic healing in rats

Bonifácio¹,

Parra²,

Almeida³

et al. 2011

Acta Cir. Bras.

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PURPOSE:To investigate the effects of cirrhosis on colonic anastomosis healing in rats. METHODS:Fifty five Wistar male rats were used (23 in the control group and 32 in the cirrhosis group). On the first day of the procedure, the rats in the cirrhosis group underwent double ligation and folding of the common bile duct to induce liver cirrhosis, and the control rats underwent a laparotomy and intestinal manipulation. On the fourteenth and thirty-fifth days, all of the animals were biochemically assessed for serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase, bilirubin, total protein, and albumin and for liver histopathology. On the thirty-fifth day, cirrhosis was confirmed. On the twenty-eighth day, all of the animals were subjected to left colon transection and anastomosis. On the seventh day after the colonic anastomosis, the rats were sacrificed and macroscopically evaluated for dehiscence. The region of the colonic anastomosis was removed and subjected to hydroxyproline content measurement, conventional histology, and the immunohistochemical determination of vascular endothelial growth factor (VEGF) and matrix metalloproteinase type 1 (MMP 1). RESULTS:The biochemical and histopathological examinations confirmed cirrhosis in all of the animals in the cirrhosis group. More deaths occurred after anastomosis in the cirrhosis group (5/25) than in the control group (0/21), and anastomotic dehiscence was more frequent in the cirrhosis group (8/25) than in the control group (0/21). The average hydroxyproline concentration was lower in the cirrhosis group than in the control group. The immunohistochemical studies showed that the average VEGF expression in the cirrhosis group was lower than in the control group, and the average MMP1 expression was higher in the cirrhosis group. CONCLUSION:Hepatic cirrhosis leads to increased mortality and colonic anastomotic dehiscence, an increased distance between the mucosal edges of the anastomosis area, and a lower hydroxyproline concentration in the colonic anastomosis; therefore, these conditions are deleterious to healing. cirrose foi confirmada. No dia 28 todos os animais foram submetidos à colectomia esquerda e anastomose. 70 dias após anastomose os ratos foram submetidos à eutanásia e foram avaliados macroscopicamente a procura de deiscência. A região da anastomose colônica foi removida para dosagem de hidroxiprolina, histologia convencional e imunohistoquímica para determinação do fator de crescimento endotelial vascular (VEGF) e metaloproteinase tipo 1 (MMP 1). RESULTADOS:A análise bioquímica e histológica confirmou a cirrose em todos os animais do grupo cirrose. Óbito ocorreu em maior freqüência após a anastomose no grupo cirrose (5/25) se comparado com grupo controle (0/21), e a deiscência da anastomose foi mais freqüente no grupo cirrose (8/25) se comparado com controle (0/21). A concentração média de hidroxiprolina foi menor no grupo cirrose se comparado com grupo controle. A análise imonuhistoquímica mostrou que a exp...

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The surgical risk of colectomy in patients with cirrhosis

Cited by 72 publications

References 7 publications

Safety of Pancreatic Surgery in Patients with Simultaneous Liver Cirrhosis: A Single Center Experience

Safety of Pancreatic Surgery in Patients with Simultaneous Liver Cirrhosis: A Single Center Experience

Cholecystolithotomy Combined Armillarisin A versus Cholecystectomy in Cirrhotic Portal Hypertension Patients with Symptomatic Cholelithiasis

Liver cirrhosis on the colonic anastomotic healing in rats

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