Perioperative Mortality After Non-hepatic General Surgery in Patients with Liver Cirrhosis: an Analysis of 138 Operations in the 2000s Using Child and MELD Scores

Abstract

Our results demonstrate that perioperative mortality remains high in patients with liver cirrhosisundergoing general surgery, especially in emergent situations. Patients with poor liver function and/or need for blood transfusions even had a very high mortality. In our experience, the Child score (together with other variables) independently correlates with perioperative mortality in emergent operations whereas the MELD score was inferior in predicting the outcome.

Duodenal stump fistula after gastric surgery for malignancies: a retrospective analysis of risk factors in a single centre experience

“…In fact, in the previously mentioned study [29], Jeong reported that the presence of chronic liver disease effects the development of post-operative complications (chronic hepatitis OR 2.4; liver cirrhosis class A OR 8.4; liver cirrhosis class B OR 9.38). Similar results were found by Neef [30] in recent retrospective series of 138 non-hepatic abdominal operations in patients with liver cirrhosis: overall and surgical morbidity rate were 64 and 47 % even in elective surgery, therefore liver cirrhosis must be considered as a high impact risk factor for all kind of abdominal surgery.…”

Model for End-stage Liver Disease

“…96 In yet another study, perioperative mortality rates based on CTP stage were 10%, 17%, and 63% while similar rates at MELD of <10, 10-15, and >15 were 9%, 19%, and 54% respectively. 97 Amongst both the studies, CTP stage emerged better predictor of perioperative mortality compared to MELD score. In contrast, integrated MELD score was superior to CTP stage for predicting postoperative mortality.…”

The liver in heart failure: a biopsy and explant series of the histopathologic and laboratory findings with a particular focus on pre-cardiac transplant evaluation

“…The risk of perioperative death is markedly increased by cirrhosis due to any cause, [3][4][5] and cirrhosis is also associated with increased post-operative complications following cardiac surgery, [6][7][8][9] including increased rates of sepsis and bleeding. Serum bilirubin has been found to correlate with operative mortality and with the presence of cardiac cirrhosis in patients with primary pulmonary hypertension undergoing heartlung transplantation.…”