[Surgical complications in cirrhotic patients. Analysis of 102 cases]

Rev Med Chil. 2019 Sep;147(9):1099-1106. doi: 10.4067/s0034-98872019000901099.
[Article in Spanish]

Abstract

Background: Cirrhotic patients have an increased surgical risk due to potential intra and postoperative complications.

Aim: To describe the clinical characteristics and surgical complications of cirrhotic patients undergoing surgery in a Chilean university hospital.

Patients and methods: Review of medical records of 102 cirrhotic patients aged 60 ± 11 years (52% males) who underwent elective or urgency surgery at an university hospital between 2010 and 2016. General, pre-surgical, and post-surgical complications were recorded.

Results: The main etiologies of cirrhosis were non-alcoholic steatohepatitis (31%), and alcoholic cirrhosis (28%). Child-Pugh scores were A, B and C in 50, 28 and 22% of cases respectively. Median MELD (Model for End-stage Liver Disease) score was 11 (interquartile range: 10-15). The surgical procedure was elective in 71% of cases, with predominance of abdominal surgery (86%). The American Society of Anesthesiologists (ASA) score was three or more in 52% of patients. The frequency of any adverse outcome was 62%. The frequency increased along with the severity of cirrhosis and when surgery was urgent. The most common complications were acute renal failure (24%), increased ascites (23%) and encephalopathy (22%). Admission to intensive care unit occurred on 26% of patients, with six hospital deaths.

Conclusions: In these patients, surgical complications were common, although with low mortality.

MeSH terms

  • Aged
  • Chile / epidemiology
  • Elective Surgical Procedures
  • End Stage Liver Disease*
  • Female
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / surgery
  • Male
  • Middle Aged
  • Severity of Illness Index