SciELO - Scientific Electronic Library Online

 
vol.138 issue9Application of a simple methodological approach to analyze health inequalities: The case of infant mortality in ChileReview on periodontal disease and metabolic control of diabetes mellitus author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

Share


Revista médica de Chile

Print version ISSN 0034-9887

Abstract

CONCHA P, MARIO  and  MERTZ K, VERÓNICA. Perioperative risk among patients with cirrhosis. Rev. méd. Chile [online]. 2010, vol.138, n.9, pp.1165-1171. ISSN 0034-9887.  http://dx.doi.org/10.4067/S0034-98872010000900013.

Ten percent of cirrhotic patients with severely compromised liver function will require a surgical procedure. This article reviews the surgical risk associated with liver damage and surgery. The most important prognostic factor is the degree of functional impairment of the liver. It is evaluated using the Child-Pugh score, which has limitations that have been partially overcome by the Model for End Stage Liver Disease (MELD) score. Cardiac surgery has the highest risk, while extra-thoracic and extra-abdominal procedures have the lowest risk. The mortality for abdominal surgery fluctuates between 11 and 76%. Biliary surgery is associated with frequent complications and mortality, which seem to decrease when the procedures are laparoscopic. There are few series that evaluate risk in Child C patients. In liver resective surgery, liver function impairment and magnitude of the excision determine the risk. A high serum creatinine, cardiac failure and emergency surgery are independent risk factors. Although MELD score is useful to predict surgical risk, decision-making must be based on an individualized evaluation of each patient and careful planning of surgical procedures.

Keywords : General surgery; Liver cirrhosis; Survival rate.

        · text in Spanish     · Spanish ( pdf )

 

Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License