肝硬化患者的非肝脏腹部手术。
Non-Hepatic Abdominal Surgery in Patients with Cirrhotic Liver Disease.
机构信息
Department of Surgery, Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Division of Acute Care Surgery, Birmingham, USA.
出版信息
J Gastrointest Surg. 2019 Mar;23(3):634-642. doi: 10.1007/s11605-018-3991-7. Epub 2018 Nov 21.
Abstract
Cirrhotic liver disease is an important cause of peri-operative morbidity and mortality in general surgical patients. Early recognition and optimization of liver dysfunction is imperative before any elective surgery. Patients with MELD <12 or classified as Child A have a higher morbidity and mortality than matched controls without liver dysfunction, but are generally safe for elective procedures with appropriate patient education. Patients with MELD >20 or classified as Child C should undergo transplantation before any elective procedure given mortality exceeds 40%. Laparoscopic procedures are feasible and safe in cirrhotic patients.
摘要
肝硬化是普通外科患者围手术期发病率和死亡率的重要原因。在进行任何择期手术前，必须早期识别和优化肝功能障碍。MELD<12 或分类为 A 级的患者比无肝功能障碍的匹配对照患者的发病率和死亡率更高，但经过适当的患者教育，一般可安全进行择期手术。MELD>20 或分类为 C 级的患者应在进行任何择期手术前进行移植，因为死亡率超过 40%。腹腔镜手术在肝硬化患者中是可行和安全的。
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