Surgical complications in cirrhotic patients. Analysis of 102 cases

Gajardo, AIJ; Poniachik, R; Freundlich, A; Vera, DB; Chesta, C; Rappoport, J; Diaz, JC; Saure, A; Castillo, J; Lembacw, H; Gonzalez, K; Navea, C; Poniachik, J

Keywords: liver cirrhosis, risk factors, intraoperative complications

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 Anes-thesiologists (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.

Más información

Título según WOS: Surgical complications in cirrhotic patients. Analysis of 102 cases
Título de la Revista: REVISTA MEDICA DE CHILE
Volumen: 147
Número: 9
Editorial: SOC MEDICA SANTIAGO
Fecha de publicación: 2019
Página de inicio: 1101
Página final: 1108
Idioma: Spanish
Notas: ISI