Adverse effects of exploratory laparotomy in patients with unsuspected liver disease

Powell-Jackson, P R; Greenway, B; Williams, Roger

doi:10.1002/bjs.1800690805

Cited by 79 publications

(20 citation statements)

References 3 publications

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“…Our study focused on portal hypertension, which is a major risk factor for the development of postoperative decompensation after open resection-even for limited resections or a simple exploratory laparotomy [4,29]. In the current series, ascites was more frequent in the OG and was associated with fatal multiple-organ failure in 4 of the 12 affected patients (due to subsequent evisceration or hemorrhagic complications), whereas none of the LG patients died from ascites.…”

Section: Discussionmentioning

confidence: 81%

Laparoscopic resection vs. open liver resection for peripheral hepatocellular carcinoma in patients with chronic liver disease: a case-matched study

et al. 2011

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Section: Discussionmentioning

confidence: 81%

Laparoscopic resection vs. open liver resection for peripheral hepatocellular carcinoma in patients with chronic liver disease: a case-matched study

et al. 2011

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“…Therefore, surgery should be avoided unless the situation is life-threatening [209] . In contrast, surgery on patients with chronic hepatitis can generally be considered safe [210] , and there have been no deaths or complications reported in patients with chronic hepatitis C undergoing laparoscopic cholecystectomy [211] .…”

Section: Risk Of Surgery In Patients With Liver Diseasesmentioning

confidence: 99%

Systemic abnormalities in liver disease

Minemura¹,

Tajiri²,

Shimizu³

2009

WJG

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“…Powell-Jackson et al 7 described 36 patients with unrecognized liver disease who had exploratory laparotomy. The overall mortality was 31%, and all those with hepatitis died.…”

Section: Discussionmentioning

confidence: 99%

Anaesthesia for caesarean section in a patient with acute fatty liver of pregnancy

Antognini¹,

Andrews²

1991

Can J Anaesth

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Jaundice and hepatic failure are rare events during pregnancy. Anaesthesia during hepatic failure is generally considered to be contraindicated except in the most life-threatening situations. 1 We report here a patient for urgent Caesarean section who had hepatic failure secondary to acute fatty liver of pregnancy (AFLP). Case reportThis 23-yr-old G2Po woman presented in acute hepatic failure at 38 wk gestation. She was well until one week before admission, when she developed general malaise with nausea. One day before admission, the nausea worsened and she had considerable vomiting and diarrhoea. At that time she also noted the onset of uterine Key wordsANAESTHESIA: obstetric; LIVER: disease.From the Department of Anesthesiology, American River Hospital, Carmichael, CA.Address correspondence to: Dr. Joseph F. Antognini, Operating Room, American River Hospital, 4747 Engle Rd., Carmichael, CA 95608.Accepted for publication 21st May, 1991. contractions and slight yellowing of her skin, but she did not have pruritus. She had no other complaints. Her past medical history was significant only for the diagnosis of Berger's disease seven years earlier, which was manifested by several episodes of asymptomatic haematuria. Biochemical evaluation six months before admission demonstrated normal blood urea nitrogen (BUN), creatinine and liver function tests.On physical examination, she appeared ill and jaundiced and was in labour. Blood pressure (BP) was 110/74 mmHg, temperature 36.6 ~ C, respirations 24 breaths per minute and heart rate 100 beats per minute (bpm). She was alert and oriented. The heart and lungs were normal. Abdominal examination revealed a 38 wk gestation pregnancy; the liver was not palpable and there was no right upper quadrant tenderness. She had no extremity or sacral oedema.Laboratory tests demonstrated acute hepatic failure with a concomitant coagulopathy, renal insufficiency, mild hypoglycaemia, metabolic acidosis (Table) and proteinuria. The clinical diagnosis was AFLP and, because of decreased fetal heart rate variability, an urgent Caesarean section was planned. Initial treatment was intravenous hydration with 3 L lactated Ringer's solution over six hours. To correct the coagulopathy vitamin K 25 mg was administered, along with two units fresh frozen plasma. During this time the BP had gradually increased to 160/100 mmHg.After the placement of a radial arterial catheter the patient was taken to the operating room and 800 ml lactated Ringer's solution were given. The BP was 165/105 mmHg, and heart rate was 145 bpm. An epidural catheter was placed at the L3-L4 interspace and 3 ml lidocaine 2% with epinephrine 1:200,000 and NaHCO3 0.1 mEq. ml-x were given without observable effect. An additional 15 ml administered over several minutes resulted in a block to T4. The patient was placed supine with left uterine displacement, and during the next 30 min the BP decreased to 120-130/60 mmHg. A viable male was born with Apgar scores of five at one minute and eight at five minutes. Epidural fentanyl, 50 p~...

show abstract

Adverse effects of exploratory laparotomy in patients with unsuspected liver disease

Cited by 79 publications

References 3 publications

Laparoscopic resection vs. open liver resection for peripheral hepatocellular carcinoma in patients with chronic liver disease: a case-matched study

Laparoscopic resection vs. open liver resection for peripheral hepatocellular carcinoma in patients with chronic liver disease: a case-matched study

Systemic abnormalities in liver disease

Anaesthesia for caesarean section in a patient with acute fatty liver of pregnancy

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