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Digestive Disease Interventions 2020; 04(02): 168-179
DOI: 10.1055/s-0040-1713370
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Management of Patients with Cirrhosis and Portal Hypertension Requiring Surgery

Dustin Carpenter 
1   Division of Transplantation, Department of Surgery, Center for Liver Disease and Transplantation, New-York Presbyterian/Columbia University Medical Center, New York, New York
,
Peter Liou
2   Division of General Surgery, Department of Surgery, New-York Presbyterian/Columbia University Medical Center, New York, New York
,
Abhishek Mathur
1   Division of Transplantation, Department of Surgery, Center for Liver Disease and Transplantation, New-York Presbyterian/Columbia University Medical Center, New York, New York
› Author Affiliations
Further Information

Publication History

19 February 2020

24 April 2020

Publication Date:
29 June 2020 (online)

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Abstract

Cirrhosis significantly increases surgical morbidity and mortality as it causes derangement of multiple organ systems and physiological processes. As such, chronic liver disease and the resultant portal hypertension present distinct perioperative challenges. The risk conveyed by liver disease is dependent on its etiology, the severity of liver dysfunction, the degree to which other organ systems are affected, and the type and timing of surgery to be performed. Careful preoperative planning as well as informed intra- and postoperative decision-making strategies are key factors in ensuring acceptable outcomes in the surgical management of cirrhotic patients. This review will discuss the challenges that cirrhosis with portal hypertension presents to the surgeon, intensivist, and anesthesiologist alike, and identifies key perioperative strategies to mitigate these risks.

Keywords

cirrhosis - portal hypertension - surgery
 

  • References

  • 1 Romanelli RG, Stasi C. Recent advancements in diagnosis and therapy of liver cirrhosis. Curr Drug Targets 2016; 17 (15) 1804-1817
    CrossrefPubMedGoogle Scholar
  • 2 Tsochatzis EA, Bosch J, Burroughs AK. Liver cirrhosis. Lancet 2014; 383 (9930): 1749-1761
    CrossrefPubMedGoogle Scholar
  • 3 Garcia-Tsao G, Abraldes JG, Berzigotti A, Bosch J. Portal hypertensive bleeding in cirrhosis: risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases. Hepatology 2017; 65 (01) 310-335
    CrossrefPubMedGoogle Scholar
  • 4 Turco L, Garcia-Tsao G. Portal hypertension: pathogenesis and diagnosis. Clin Liver Dis 2019; 23 (04) 573-587
    CrossrefPubMedGoogle Scholar
  • 5 Turco L, Garcia-Tsao G, Magnani I. , et al. Cardiopulmonary hemodynamics and C-reactive protein as prognostic indicators in compensated and decompensated cirrhosis. J Hepatol 2018; 68 (05) 949-958
    CrossrefPubMedGoogle Scholar
  • 6 Ripoll C, Bañares R, Rincón D. , et al. Influence of hepatic venous pressure gradient on the prediction of survival of patients with cirrhosis in the MELD Era. Hepatology 2005; 42 (04) 793-801
    CrossrefPubMedGoogle Scholar
  • 7 D'Amico G, Garcia-Tsao G, Pagliaro L. Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies. J Hepatol 2006; 44 (01) 217-231
    CrossrefPubMedGoogle Scholar
  • 8 de Franchis R. ; Baveno VI Faculty. Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol 2015; 63 (03) 743-752
    CrossrefPubMedGoogle Scholar
  • 9 Scaglione S, Kliethermes S, Cao G. , et al. The epidemiology of cirrhosis in the United States: a population-based study. J Clin Gastroenterol 2015; 49 (08) 690-696
    CrossrefPubMedGoogle Scholar
  • 10 D'Amico G, Pasta L, Morabito A. , et al. Competing risks and prognostic stages of cirrhosis: a 25-year inception cohort study of 494 patients. Aliment Pharmacol Ther 2014; 39 (10) 1180-1193
    CrossrefPubMedGoogle Scholar
  • 11 D'Amico G, Morabito A, D'Amico M. , et al. New concepts on the clinical course and stratification of compensated and decompensated cirrhosis. Hepatol Int 2018; 12 (Suppl. 01) 34-43
    CrossrefPubMedGoogle Scholar
  • 12 Teh SH, Nagorney DM, Stevens SR. , et al. Risk factors for mortality after surgery in patients with cirrhosis. Gastroenterology 2007; 132 (04) 1261-1269
    CrossrefPubMedGoogle Scholar
  • 13 Ziser A, Plevak DJ. Morbidity and mortality in cirrhotic patients undergoing anesthesia and surgery. Curr Opin Anaesthesiol 2001; 14 (06) 707-711
    CrossrefPubMedGoogle Scholar
  • 14 Northup PG, Friedman LS, Kamath PS. AGA Clinical Practice Update on surgical risk assessment and perioperative management in cirrhosis: expert review. Clin Gastroenterol Hepatol 2019; 17 (04) 595-606
    CrossrefPubMedGoogle Scholar
  • 15 Garcia-Tsao G. Portal hypertension. Curr Opin Gastroenterol 2006; 22 (03) 254-262
    PubMedGoogle Scholar
  • 16 Kumar A, Sharma P, Sarin SK. Hepatic venous pressure gradient measurement: time to learn!. Indian J Gastroenterol 2008; 27 (02) 74-80
    PubMedGoogle Scholar
  • 17 Abraldes JG, Villanueva C, Bañares R. , et al; Spanish Cooperative Group for Portal Hypertension and Variceal Bleeding. Hepatic venous pressure gradient and prognosis in patients with acute variceal bleeding treated with pharmacologic and endoscopic therapy. J Hepatol 2008; 48 (02) 229-236
    CrossrefPubMedGoogle Scholar
  • 18 Bureau C, Thabut D, Oberti F. , et al. Transjugular intrahepatic portosystemic shunts with covered stents increase transplant-free survival of patients with cirrhosis and recurrent ascites. Gastroenterology 2017; 152 (01) 157-163
    CrossrefPubMedGoogle Scholar
  • 19 García-Pagán JC, Caca K, Bureau C. , et al; Early TIPS (Transjugular Intrahepatic Portosystemic Shunt) Cooperative Study Group. Early use of TIPS in patients with cirrhosis and variceal bleeding. N Engl J Med 2010; 362 (25) 2370-2379
    CrossrefPubMedGoogle Scholar
  • 20 Turco L, Villanueva C, La Mura V. , et al. Lowering portal pressure improves outcomes of patients with cirrhosis, with or without ascites: a meta-analysis. Clin Gastroenterol Hepatol 2020; 18 (02) 313-327.e6
    CrossrefPubMedGoogle Scholar
  • 21 Asrani SK, Devarbhavi H, Eaton J, Kamath PS. Burden of liver diseases in the world. J Hepatol 2019; 70 (01) 151-171
    CrossrefPubMedGoogle Scholar
  • 22 Jackson FC, Christophersen EB, Peternel WW, Kirimli B. Preoperative management of patients with liver disease. Surg Clin North Am 1968; 48 (04) 907-930
    CrossrefPubMedGoogle Scholar
  • 23 Garrison RN, Cryer HM, Howard DA, Polk Jr HC. Clarification of risk factors for abdominal operations in patients with hepatic cirrhosis. Ann Surg 1984; 199 (06) 648-655
    CrossrefPubMedGoogle Scholar
  • 24 Mansour A, Watson W, Shayani V, Pickleman J. Abdominal operations in patients with cirrhosis: still a major surgical challenge. Surgery 1997; 122 (04) 730-735 , discussion 735–736
    CrossrefPubMedGoogle Scholar
  • 25 de Goede B, Klitsie PJ, Lange JF, Metselaar HJ, Kazemier G. Morbidity and mortality related to non-hepatic surgery in patients with liver cirrhosis: a systematic review. Best Pract Res Clin Gastroenterol 2012; 26 (01) 47-59
    PubMedGoogle Scholar
  • 26 Friedman LS. The risk of surgery in patients with liver disease. Hepatology 1999; 29 (06) 1617-1623
    CrossrefPubMedGoogle Scholar
  • 27 Friedman LS. Surgery in the patient with liver disease. Trans Am Clin Climatol Assoc 2010; 121: 192-204 , discussion 205
    PubMedGoogle Scholar
  • 28 O'Leary JG, Yachimski PS, Friedman LS. Surgery in the patient with liver disease. Clin Liver Dis 2009; 13 (02) 211-231
    CrossrefPubMedGoogle Scholar
  • 29 Jang HJ, Kim JH, Song HH. , et al. Clinical outcomes of patients with liver cirrhosis who underwent curative surgery for gastric cancer: a retrospective multi-center study. Dig Dis Sci 2008; 53 (02) 399-404
    CrossrefPubMedGoogle Scholar
  • 30 Laurence JM, Tran PD, Richardson AJ, Pleass HC, Lam VW. Laparoscopic or open cholecystectomy in cirrhosis: a systematic review of outcomes and meta-analysis of randomized trials. HPB (Oxford) 2012; 14 (03) 153-161
    CrossrefPubMedGoogle Scholar
  • 31 Quillin III RC, Burns JM, Pineda JA. , et al. Laparoscopic cholecystectomy in the cirrhotic patient: predictors of outcome. Surgery 2013; 153 (05) 634-640
    CrossrefPubMedGoogle Scholar
  • 32 Sozzi M, Siboni S, Asti E, Bonitta G, Bonavina L. Short-term outcomes of minimally invasive esophagectomy for carcinoma in patients with liver cirrhosis. J Laparoendosc Adv Surg Tech A 2017; 27 (06) 592-596
    CrossrefPubMedGoogle Scholar
  • 33 Wang ZQ, Deng HY, Yang YS. , et al. Can oesophagectomy be performed for patients with oesophageal carcinoma and concomitant liver cirrhosis? A retrospective study based on a propensity-matched cohort. Interact Cardiovasc Thorac Surg 2017; 25 (03) 442-447
    CrossrefPubMedGoogle Scholar
  • 34 Reynolds TM. ; National Institute for Health and Clinical Excellence; Clinical Scince Reviews Committee of the Association for Clinical Biochemistry. National Institute for Health and Clinical Excellence guidelines on preoperative tests: the use of routine preoperative tests for elective surgery. Ann Clin Biochem 2006; 43 (Pt 1): 13-16
    CrossrefPubMedGoogle Scholar
  • 35 Fleisher LA, Fleischmann KE, Auerbach AD. , et al; American College of Cardiology; American Heart Association. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol 2014; 64 (22) e77-e137
    CrossrefPubMedGoogle Scholar
  • 36 Feely MA, Collins CS, Daniels PR, Kebede EB, Jatoi A, Mauck KF. Preoperative testing before noncardiac surgery: guidelines and recommendations. Am Fam Physician 2013; 87 (06) 414-418
    PubMedGoogle Scholar
  • 37 Hay JE, Czaja AJ, Rakela J, Ludwig J. The nature of unexplained chronic aminotransferase elevations of a mild to moderate degree in asymptomatic patients. Hepatology 1989; 9 (02) 193-197
    CrossrefPubMedGoogle Scholar
  • 38 Hanje AJ, Patel T. Preoperative evaluation of patients with liver disease. Nat Clin Pract Gastroenterol Hepatol 2007; 4 (05) 266-276
    PubMedGoogle Scholar
  • 39 Lee TH, Marcantonio ER, Mangione CM. , et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation 1999; 100 (10) 1043-1049
    CrossrefPubMedGoogle Scholar
  • 40 Bilimoria KY, Liu Y, Paruch JL. , et al. Development and evaluation of the universal ACS NSQIP surgical risk calculator: a decision aid and informed consent tool for patients and surgeons. J Am Coll Surg 2013; 217 (05) 833-42.e1 , 3
    CrossrefPubMedGoogle Scholar
  • 41 Zaydfudim VM, Turrentine FE, Smolkin ME, Bauer TB, Adams RB, McMurry TL. The impact of cirrhosis and MELD score on postoperative morbidity and mortality among patients selected for liver resection. Am J Surg 2020; (e-pub ahead of print) DOI: 10.1016/j.amjsurg.2020.01.022.
    CrossrefPubMedGoogle Scholar
  • 42 Child CG, Turcotte JG. Surgery and portal hypertension. Major Probl Clin Surg 1964; 1: 1-85
    PubMedGoogle Scholar
  • 43 Farnsworth N, Fagan SP, Berger DH, Awad SS. Child-Turcotte-Pugh versus MELD score as a predictor of outcome after elective and emergent surgery in cirrhotic patients. Am J Surg 2004; 188 (05) 580-583
    CrossrefPubMedGoogle Scholar
  • 44 Durand F, Valla D. Assessment of the prognosis of cirrhosis: Child-Pugh versus MELD. J Hepatol 2005; 42 (1, Suppl): S100-S107
    CrossrefPubMedGoogle Scholar
  • 45 Planas R, Montoliu S, Ballesté B. , et al. Natural history of patients hospitalized for management of cirrhotic ascites. Clin Gastroenterol Hepatol 2006; 4 (11) 1385-1394
    CrossrefPubMedGoogle Scholar
  • 46 Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, ter Borg PC. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology 2000; 31 (04) 864-871
    CrossrefPubMedGoogle Scholar
  • 47 Wiesner R, Edwards E, Freeman R. , et al; United Network for Organ Sharing Liver Disease Severity Score Committee. Model for end-stage liver disease (MELD) and allocation of donor livers. Gastroenterology 2003; 124 (01) 91-96
    CrossrefPubMedGoogle Scholar
  • 48 Northup PG, Wanamaker RC, Lee VD, Adams RB, Berg CL. Model for End-Stage Liver Disease (MELD) predicts nontransplant surgical mortality in patients with cirrhosis. Ann Surg 2005; 242 (02) 244-251
    CrossrefPubMedGoogle Scholar
  • 49 Befeler AS, Palmer DE, Hoffman M, Longo W, Solomon H, Di Bisceglie AM. The safety of intra-abdominal surgery in patients with cirrhosis: model for end-stage liver disease score is superior to Child-Turcotte-Pugh classification in predicting outcome. Arch Surg 2005; 140 (07) 650-654 , discussion 655
    PubMedGoogle Scholar
  • 50 Biggins SW, Rodriguez HJ, Bacchetti P, Bass NM, Roberts JP, Terrault NA. Serum sodium predicts mortality in patients listed for liver transplantation. Hepatology 2005; 41 (01) 32-39
    CrossrefPubMedGoogle Scholar
  • 51 Heuman DM, Abou-Assi SG, Habib A. , et al. Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death. Hepatology 2004; 40 (04) 802-810
    CrossrefPubMedGoogle Scholar
  • 52 Godfrey EL, Kueht ML, Rana A, Awad S. MELD-Na (the new MELD) and peri-operative outcomes in emergency surgery. Am J Surg 2018; 216 (03) 407-413
    CrossrefPubMedGoogle Scholar
  • 53 Causey MW, Steele SR, Farris Z, Lyle DS, Beitler AL. An assessment of different scoring systems in cirrhotic patients undergoing nontransplant surgery. Am J Surg 2012; 203 (05) 589-593
    CrossrefPubMedGoogle Scholar
  • 54 Rai R, Nagral S, Nagral A. Surgery in a patient with liver disease. J Clin Exp Hepatol 2012; 2 (03) 238-246
    CrossrefPubMedGoogle Scholar
  • 55 Newman KL, Johnson KM, Cornia PB, Wu P, Itani K, Ioannou GN. Perioperative evaluation and management of patients with cirrhosis: risk assessment, surgical outcomes, and future directions. Clin Gastroenterol Hepatol 2019; (e-pub ahead of print) DOI: 10.1016/j.cgh.2019.07.051.
    CrossrefPubMedGoogle Scholar
  • 56 Im GY, Lubezky N, Facciuto ME, Schiano TD. Surgery in patients with portal hypertension: a preoperative checklist and strategies for attenuating risk. Clin Liver Dis 2014; 18 (02) 477-505
    CrossrefPubMedGoogle Scholar
  • 57 Marik PE, Varon J. Requirement of perioperative stress doses of corticosteroids: a systematic review of the literature. Arch Surg 2008; 143 (12) 1222-1226
    PubMedGoogle Scholar
  • 58 Yarze JC, Munoz SJ, Friedman LS. Diagnosing Wilson disease. Ann Intern Med 1992; 117 (01) 91
    PubMedGoogle Scholar
  • 59 Zamorano DP, Lim PK, Haghverdian BA, Gupta R. Perioperative management of the orthopaedic patient and alcohol use, abuse, and withdrawal. J Am Acad Orthop Surg 2019; 27 (06) e249-e257
    CrossrefPubMedGoogle Scholar
  • 60 Egholm JW, Pedersen B, Møller AM, Adami J, Juhl CB, Tønnesen H. Perioperative alcohol cessation intervention for postoperative complications. Cochrane Database Syst Rev 2018; 11: CD008343
    PubMedGoogle Scholar
  • 61 Nguyen GC, Correia AJ, Thuluvath PJ. The impact of cirrhosis and portal hypertension on mortality following colorectal surgery: a nationwide, population-based study. Dis Colon Rectum 2009; 52 (08) 1367-1374
    CrossrefPubMedGoogle Scholar
  • 62 El Nakeeb A, Sultan AM, Salah T. , et al. Impact of cirrhosis on surgical outcome after pancreaticoduodenectomy. World J Gastroenterol 2013; 19 (41) 7129-7137
    CrossrefPubMedGoogle Scholar
  • 63 Kim JJ, Dasika NL, Yu E, Fontana RJ. Cirrhotic patients with a transjugular intrahepatic portosystemic shunt undergoing major extrahepatic surgery. J Clin Gastroenterol 2009; 43 (06) 574-579
    CrossrefPubMedGoogle Scholar
  • 64 Azoulay D, Buabse F, Damiano I. , et al. Neoadjuvant transjugular intrahepatic portosystemic shunt: a solution for extrahepatic abdominal operation in cirrhotic patients with severe portal hypertension. J Am Coll Surg 2001; 193 (01) 46-51
    CrossrefPubMedGoogle Scholar
  • 65 Odom SR, Gupta A, Talmor D, Novack V, Sagy I, Evenson AR. Emergency hernia repair in cirrhotic patients with ascites. J Trauma Acute Care Surg 2013; 75 (03) 404-409
    CrossrefPubMedGoogle Scholar
  • 66 Bleszynski MS, Bressan AK, Joos E, Morad Hameed S, Ball CG. Acute care and emergency general surgery in patients with chronic liver disease: how can we optimize perioperative care? A review of the literature. World J Emerg Surg 2018; 13: 32
    CrossrefPubMedGoogle Scholar
  • 67 Moreau R, Lebrec D. Diagnosis and treatment of acute renal failure in patients with cirrhosis. Best Pract Res Clin Gastroenterol 2007; 21 (01) 111-123
    PubMedGoogle Scholar
  • 68 Lahat E, Lim C, Bhangui P. , et al. Transjugular intrahepatic portosystemic shunt as a bridge to non-hepatic surgery in cirrhotic patients with severe portal hypertension: a systematic review. HPB (Oxford) 2018; 20 (02) 101-109
    CrossrefPubMedGoogle Scholar
  • 69 Telem DA, Schiano T, Divino CM. Complicated hernia presentation in patients with advanced cirrhosis and refractory ascites: management and outcome. Surgery 2010; 148 (03) 538-543
    CrossrefPubMedGoogle Scholar
  • 70 Vinet E, Perreault P, Bouchard L. , et al. Transjugular intrahepatic portosystemic shunt before abdominal surgery in cirrhotic patients: a retrospective, comparative study. Can J Gastroenterol 2006; 20 (06) 401-404
    CrossrefPubMedGoogle Scholar
  • 71 Villanueva C, Aracil C, Colomo A. , et al. Acute hemodynamic response to beta-blockers and prediction of long-term outcome in primary prophylaxis of variceal bleeding. Gastroenterology 2009; 137 (01) 119-128
    CrossrefPubMedGoogle Scholar
  • 72 Nijhawan S, Rai RR, Nepalia S, Pokharana DS, Bharagava N. Natural history of postligation ulcers. Am J Gastroenterol 1994; 89 (12) 2281-2282
    PubMedGoogle Scholar
  • 73 Afdhal N, McHutchison J, Brown R. , et al. Thrombocytopenia associated with chronic liver disease. J Hepatol 2008; 48 (06) 1000-1007
    CrossrefPubMedGoogle Scholar
  • 74 Rahbari NN, Reissfelder C, Koch M. , et al. The predictive value of postoperative clinical risk scores for outcome after hepatic resection: a validation analysis in 807 patients. Ann Surg Oncol 2011; 18 (13) 3640-3649
    CrossrefPubMedGoogle Scholar
  • 75 O'Leary JG, Greenberg CS, Patton HM, Caldwell SH. AGA Clinical Practice Update: coagulation in cirrhosis. Gastroenterology 2019; 157 (01) 34-43.e1
    CrossrefPubMedGoogle Scholar
  • 76 Stravitz RT. Potential applications of thromboelastography in patients with acute and chronic liver disease. Gastroenterol Hepatol (N Y) 2012; 8 (08) 513-520
    PubMedGoogle Scholar
  • 77 Wong F, Girgrah N, Graba J, Allidina Y, Liu P, Blendis L. The cardiac response to exercise in cirrhosis. Gut 2001; 49 (02) 268-275
    CrossrefPubMedGoogle Scholar
  • 78 Sort P, Navasa M, Arroyo V. , et al. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis. N Engl J Med 1999; 341 (06) 403-409
    CrossrefPubMedGoogle Scholar
  • 79 Pomier-Layrargues G, Paquin SC, Hassoun Z, Lafortune M, Tran A. Octreotide in hepatorenal syndrome: a randomized, double-blind, placebo-controlled, crossover study. Hepatology 2003; 38 (01) 238-243
    PubMedGoogle Scholar
  • 80 Rodríguez-Roisin R, Krowka MJ, Hervé P, Fallon MB. ; ERS Task Force Pulmonary-Hepatic Vascular Disorders (PHD) Scientific Committee. Pulmonary-hepatic vascular disorders (PHD). Eur Respir J 2004; 24 (05) 861-880
    CrossrefPubMedGoogle Scholar
  • 81 Nayyar D, Man HS, Granton J, Lilly LB, Gupta S. Proposed management algorithm for severe hypoxemia after liver transplantation in the hepatopulmonary syndrome. Am J Transplant 2015; 15 (04) 903-913
    CrossrefPubMedGoogle Scholar
  • 82 Verbeeck RK. Pharmacokinetics and dosage adjustment in patients with hepatic dysfunction. Eur J Clin Pharmacol 2008; 64 (12) 1147-1161
    CrossrefPubMedGoogle Scholar
  • 83 Benson GD. Hepatotoxicity following the therapeutic use of antipyretic analgesics. Am J Med 1983; 75 (5A): 85-93
    PubMedGoogle Scholar
  • 84 Benson GD. Acetaminophen in chronic liver disease. Clin Pharmacol Ther 1983; 33 (01) 95-101
    CrossrefPubMedGoogle Scholar
  • 85 Eltawil KM, Laryea M, Peltekian K, Molinari M. Rifaximin vs. conventional oral therapy for hepatic encephalopathy: a meta-analysis. World J Gastroenterol 2012; 18 (08) 767-777
    CrossrefPubMedGoogle Scholar
  • 86 Tsiaousi ET, Hatzitolios AI, Trygonis SK, Savopoulos CG. Malnutrition in end stage liver disease: recommendations and nutritional support. J Gastroenterol Hepatol 2008; 23 (04) 527-533
    CrossrefPubMedGoogle Scholar
  • 87 Kim G, Kang SH, Kim MY, Baik SK. Prognostic value of sarcopenia in patients with liver cirrhosis: A systematic review and meta-analysis. PLoS One 2017; 12 (10) e0186990
    CrossrefPubMedGoogle Scholar
  • 88 Amodio P, Bemeur C, Butterworth R. , et al. The nutritional management of hepatic encephalopathy in patients with cirrhosis: International Society for Hepatic Encephalopathy and Nitrogen Metabolism Consensus. Hepatology 2013; 58 (01) 325-336
    CrossrefPubMedGoogle Scholar
  • 89 Fan ST, Lo CM, Lai EC, Chu KM, Liu CL, Wong J. Perioperative nutritional support in patients undergoing hepatectomy for hepatocellular carcinoma. N Engl J Med 1994; 331 (23) 1547-1552
    CrossrefPubMedGoogle Scholar
  • 90 Jalan R, Fernandez J, Wiest R. , et al. Bacterial infections in cirrhosis: a position statement based on the EASL Special Conference 2013. J Hepatol 2014; 60 (06) 1310-1324
    CrossrefPubMedGoogle Scholar
  • 91 Merion RM, Schaubel DE, Dykstra DM, Freeman RB, Port FK, Wolfe RA. The survival benefit of liver transplantation. Am J Transplant 2005; 5 (02) 307-313
    CrossrefPubMedGoogle Scholar
  • 92 Cowan RE, Jackson BT, Grainger SL, Thompson RP. Effects of anesthetic agents and abdominal surgery on liver blood flow. Hepatology 1991; 14 (06) 1161-1166
    PubMedGoogle Scholar
  • 93 Gelman S, Dillard E, Bradley Jr EL. Hepatic circulation during surgical stress and anesthesia with halothane, isoflurane, or fentanyl. Anesth Analg 1987; 66 (10) 936-943
    PubMedGoogle Scholar
  • 94 Njoku D, Laster MJ, Gong DH, Eger II EI, Reed GF, Martin JL. Biotransformation of halothane, enflurane, isoflurane, and desflurane to trifluoroacetylated liver proteins: association between protein acylation and hepatic injury. Anesth Analg 1997; 84 (01) 173-178
    CrossrefPubMedGoogle Scholar
  • 95 Delcò F, Tchambaz L, Schlienger R, Drewe J, Krähenbühl S. Dose adjustment in patients with liver disease. Drug Saf 2005; 28 (06) 529-545
    CrossrefPubMedGoogle Scholar
  • 96 Servin F, Desmonts JM, Haberer JP, Cockshott ID, Plummer GF, Farinotti R. Pharmacokinetics and protein binding of propofol in patients with cirrhosis. Anesthesiology 1988; 69 (06) 887-891
    CrossrefPubMedGoogle Scholar
  • 97 van Beem H, Manger FW, van Boxtel C, van Bentem N. Etomidate anaesthesia in patients with cirrhosis of the liver: pharmacokinetic data. Anaesthesia 1983; 38 (Suppl): 61-62
    CrossrefPubMedGoogle Scholar
  • 98 Correia LM, Bonilha DQ, Gomes GF. , et al. Sedation during upper GI endoscopy in cirrhotic outpatients: a randomized, controlled trial comparing propofol and fentanyl with midazolam and fentanyl. Gastrointest Endosc 2011; 73 (01) 45-51 , 51.e1
    CrossrefPubMedGoogle Scholar
  • 99 Khamaysi I, William N, Olga A. , et al. Sub-clinical hepatic encephalopathy in cirrhotic patients is not aggravated by sedation with propofol compared to midazolam: a randomized controlled study. J Hepatol 2011; 54 (01) 72-77
    CrossrefPubMedGoogle Scholar
  • 100 Sharma P, Singh S, Sharma BC. , et al. Propofol sedation during endoscopy in patients with cirrhosis, and utility of psychometric tests and critical flicker frequency in assessment of recovery from sedation. Endoscopy 2011; 43 (05) 400-405
    Article in Thieme ConnectPubMedGoogle Scholar
  • 101 Dumont L, Picard V, Marti RA, Tassonyi E. Use of remifentanil in a patient with chronic hepatic failure. Br J Anaesth 1998; 81 (02) 265-267
    CrossrefPubMedGoogle Scholar
  • 102 Magorian T, Wood P, Caldwell J. , et al. The pharmacokinetics and neuromuscular effects of rocuronium bromide in patients with liver disease. Anesth Analg 1995; 80 (04) 754-759
    PubMedGoogle Scholar
  • 103 Abdulatif M, Lotfy M, Mousa M, Afifi MH, Yassen K. Sugammadex antagonism of rocuronium-induced neuromuscular blockade in patients with liver cirrhosis undergoing liver resection: a randomized controlled study. Minerva Anestesiol 2018; 84 (08) 929-937
    PubMedGoogle Scholar
  • 104 Kisor DF, Schmith VD, Wargin WA, Lien CA, Ornstein E, Cook DR. Importance of the organ-independent elimination of cisatracurium. Anesth Analg 1996; 83 (05) 1065-1071
    CrossrefPubMedGoogle Scholar
  • 105 Poggio JL, Rowland CM, Gores GJ, Nagorney DM, Donohue JH. A comparison of laparoscopic and open cholecystectomy in patients with compensated cirrhosis and symptomatic gallstone disease. Surgery 2000; 127 (04) 405-411
    CrossrefPubMedGoogle Scholar
  • 106 Yerdel MA, Koksoy C, Aras N, Orita K. Laparoscopic versus open cholecystectomy in cirrhotic patients: a prospective study. Surg Laparosc Endosc 1997; 7 (06) 483-486
    CrossrefPubMedGoogle Scholar
  • 107 Lledó JB, Ibañez JC, Mayor LG, Juan MB. Laparoscopic cholecystectomy and liver cirrhosis. Surg Laparosc Endosc Percutan Tech 2011; 21 (06) 391-395
    CrossrefPubMedGoogle Scholar
  • 108 Okamuro K, Cui B, Moazzez A. , et al. Laparoscopic cholecystectomy is safe in emergency general surgery patients with cirrhosis. Am Surg 2019; 85 (10) 1146-1149
    PubMedGoogle Scholar
  • 109 de Goede B, Klitsie PJ, Hagen SM. , et al. Meta-analysis of laparoscopic versus open cholecystectomy for patients with liver cirrhosis and symptomatic cholecystolithiasis. Br J Surg 2013; 100 (02) 209-216
    CrossrefPubMedGoogle Scholar
  • 110 Garcia M, Gerber A, Zakhary B. , et al. Management and outcomes of acute appendicitis in the presence of cirrhosis: a nationwide analysis. Am Surg 2019; 85 (10) 1129-1133
    PubMedGoogle Scholar
  • 111 Narita M, Oussoultzoglou E, Bachellier P, Jaeck D, Uemoto S. Post-hepatectomy liver failure in patients with colorectal liver metastases. Surg Today 2015; 45 (10) 1218-1226
    CrossrefPubMedGoogle Scholar
  • 112 Teh SH, Christein J, Donohue J. , et al. Hepatic resection of hepatocellular carcinoma in patients with cirrhosis: Model of End-Stage Liver Disease (MELD) score predicts perioperative mortality. J Gastrointest Surg 2005; 9 (09) 1207-1215 , discussion 1215
    CrossrefPubMedGoogle Scholar
  • 113 Chin KM, Allen JC, Teo JY. , et al. Predictors of post-hepatectomy liver failure in patients undergoing extensive liver resections for hepatocellular carcinoma. Ann Hepatobiliary Pancreat Surg 2018; 22 (03) 185-196
    CrossrefPubMedGoogle Scholar
  • 114 Zou H, Yang X, Li QL, Zhou QX, Xiong L, Wen Y. A comparative study of albumin-bilirubin score with Child-Pugh score, Model for End-Stage Liver Disease score and indocyanine green R15 in predicting posthepatectomy liver failure for hepatocellular carcinoma patients. Dig Dis 2018; 36 (03) 236-243
    CrossrefPubMedGoogle Scholar
  • 115 Croome KP, Yamashita MH. Laparoscopic vs open hepatic resection for benign and malignant tumors: an updated meta-analysis. Arch Surg 2010; 145 (11) 1109-1118
    Google Scholar
  • 116 Memeo R, de'Angelis N, Compagnon P. , et al. Laparoscopic vs. open liver resection for hepatocellular carcinoma of cirrhotic liver: a case-control study. World J Surg 2014; 38 (11) 2919-2926
    CrossrefPubMedGoogle Scholar
  • 117 Cipriani F, Fantini C, Ratti F. , et al. Laparoscopic liver resections for hepatocellular carcinoma. Can we extend the surgical indication in cirrhotic patients?. Surg Endosc 2018; 32 (02) 617-626
    CrossrefPubMedGoogle Scholar
  • 118 Oh HK, Kim H, Ryoo S, Choe EK, Park KJ. Inguinal hernia repair in patients with cirrhosis is not associated with increased risk of complications and recurrence. World J Surg 2011; 35 (06) 1229-1233 , discussion 1234
    CrossrefPubMedGoogle Scholar
  • 119 Juo YY, Skancke M, Holzmacher J, Amdur RL, Lin PP, Vaziri K. Laparoscopic versus open ventral hernia repair in patients with chronic liver disease. Surg Endosc 2017; 31 (02) 769-777
    CrossrefPubMedGoogle Scholar
  • 120 Shimizu H, Phuong V, Maia M. , et al. Bariatric surgery in patients with liver cirrhosis. Surg Obes Relat Dis 2013; 9 (01) 1-6
    CrossrefPubMedGoogle Scholar
  • 121 Miñambres I, Rubio MA, de Hollanda A. , et al. Outcomes of bariatric surgery in patients with cirrhosis. Obes Surg 2019; 29 (02) 585-592
    CrossrefPubMedGoogle Scholar