Preoperative evaluation of patients with liver disease

• Published in: Nature clinical practice. Gastroenterology & hepatology Vol. 4; no. 5; pp. 266 - 276
• Main Authors: Patel, Tushar, Hanje, A James
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 01.05.2007
• Subjects: Acute Disease; Analysis; Care and treatment; Chronic Disease; Digestive System Surgical Procedures - adverse effects; Humans; Liver diseases; Liver Diseases - physiopathology; Liver Diseases - surgery; Patient outcomes; Postoperative Complications - prevention & control; Preoperative Care; Risk Assessment; Risk factors; Severity of Illness Index; United States
• ISSN: 1743-4378; 1759-5045; 1743-4386; 1759-5053
• DOI: 10.1038/ncpgasthep0794

Patients with end-stage liver disease often undergo surgery for indications other than liver transplantation. These patients have an increased risk of morbidity and mortality that is related to their underlying liver disease. Assessments of surgical risk provide a basis for discussion of risks and benefits, treatment decision making, and for optimal management of patients for whom surgery is planned. The most useful indicators of surgical risk are indices that predict advanced disease, such as the Child-Turcotte-Pugh score, or those that predict prognosis, such as the Model for End-stage Liver Disease score. Careful preoperative risk assessment, patient selection, and management of various manifestations of advanced disease might decrease morbidity and mortality from nontransplant surgery in patients with liver disease.