Riesgo perioperatorio en pacientes con cirrosis hepática / Perioperative risk among patients with cirrhosis
Rev. méd. Chile
; 138(9): 1165-1171, sept. 2010. tab
Article
em Es
| LILACS
| ID: lil-572025
Biblioteca responsável:
CL1.1
ABSTRACT
Ten percent of cirrhotic patients with severely compromised liver function will require a surgical procedure. This article reviews the surgical risk associated with liver damage and surgery. The most important prognostic factor is the degree of functional impairment of the liver. It is evaluated using the Child-Pugh score, which has limitations that have been partially overcome by the Model for End Stage Liver Disease (MELD) score. Cardiac surgery has the highest risk, while extra-thoracic and extra-abdominal procedures have the lowest risk. The mortality for abdominal surgery fluctuates between 11 and 76 percent. Biliary surgery is associated with frequent complications and mortality, which seem to decrease when the procedures are laparoscopic. There are few series that evaluate risk in Child C patients. In liver resective surgery, liver function impairment and magnitude of the excision determine the risk. A high serum creatinine, cardiac failure and emergency surgery are independent risk factors. Although MELD score is useful to predict surgical risk, decision-making must be based on an individualized evaluation of each patient and careful planning of surgical procedures.
Palavras-chave
Texto completo:
1
Índice:
LILACS
Assunto principal:
Complicações Pós-Operatórias
/
Período Perioperatório
/
Cirrose Hepática
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
Es
Revista:
Rev. méd. Chile
Assunto da revista:
MEDICINA
Ano de publicação:
2010
Tipo de documento:
Article