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Revista médica de Chile · Sep 2019
[Surgical complications in cirrhotic patients. Analysis of 102 cases].
- Abraham Ij Gajardo, Rafael Poniachik, Alejandro Freundlich, Daniela B Vera, Caterina Chesta, Jaime Rappoport, Juan Carlos Díaz, Alexandre Saure, Jaime Castillo, Hans Lembach, Katherine González, César Navea, and Jaime Poniachik.
- Sección de Gastroenterología, Universidad de Chile, Santiago, Chile.
- Rev Med Chil. 2019 Sep 1; 147 (9): 1099-1106.
BackgroundCirrhotic patients have an increased surgical risk due to potential intra and postoperative complications.AimTo describe the clinical characteristics and surgical complications of cirrhotic patients undergoing surgery in a Chilean university hospital.Patients And MethodsReview 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.ResultsThe 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.ConclusionsIn these patients, surgical complications were common, although with low mortality.
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