Safety and effectiveness of inguinal hernia repair in patients with liver cirrhosis: a retrospective study and literature review

Hernia. 2020 Jun;24(3):489-494. doi: 10.1007/s10029-019-02087-4. Epub 2019 Nov 26.

Abstract

Purpose: Inguinal hernia is a common feature of decompensated liver cirrhosis and a frequent cause of life-threatening complications. The traditional treatment of inguinal hernia in patients with liver cirrhosis includes non-operative management; however, emerging data suggest elective surgical repair as a preferable approach. Therefore, we aimed to assess the outcomes of inguinal hernia repair in patients with liver cirrhosis and describe their clinical characteristics.

Methods: In this retrospective study, we included a total of 28 consecutive patients with liver cirrhosis who underwent inguinal hernia repair between March 2000 and May 2019 at the First People's Hospital of Xiaoshan, Hangzhou, China. We also reviewed the literature on inguinal hernia repair in patients with liver cirrhosis.

Results: Emergency surgery for complicated hernia was performed in 17.9% of the study patients. Two patients developed major complications including wound hematoma in 1, who required reoperation, and gastrointestinal tract hemorrhage in the other patient, who required blood transfusion. Further, minor complications developed in 6 patients, including wound seroma in 1 and scrotal swelling in 5. Emergency hernia repair was found to be associated with a higher complication rate than elective surgery in patients with liver cirrhosis.

Conclusion: Elective surgery for inguinal hernia repair in patients with liver cirrhosis appears to be successful and might be associated with a lower complication rate than emergency surgery. Inguinal hernia repair is recommended for patients with liver cirrhosis to prevent the development of life-threatening complications.

Keywords: Ascites; Complication rate; Inguinal hernia repair; Liver cirrhosis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Elective Surgical Procedures / adverse effects
  • Female
  • Hernia, Inguinal / complications
  • Hernia, Inguinal / surgery*
  • Herniorrhaphy* / adverse effects
  • Humans
  • Liver Cirrhosis* / complications
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome