Assessing and Managing the Risk of Surgery in Patients with Liver Disease

Abstract

Advancements in medical science have led to the development of complex surgeries that improve survival in patients with liver disease. Assessments of the indications and contraindications for surgery and risk factors are the most important steps prior to any surgery in this population. Particular attention is essential to assess for the presence of pre-surgical ascites, hepatic encephalopathy and renal dysfunction. The most important risk factors for that increase mortality include anemia, ascites, hepatic encephalopathy, hypoalbuminemia, hypoxemia, concurrent infections, malnutrition, elevated Child Pugh and MELD scores,portal hypertension, prolonged prothrombin time and type of surgery. Advancements in anesthesiology have prevented surgical complications among patients with liver disease. Increased symptoms of liver failure and complications result in high mortality following surgery. This review article presents useful recommendations for safe surgery among patients with liver disease who are surgical candidates.