Non-Hepatic Surgery in Chronic Liver Disease Patients: What are the Risks?

Abstract

Background and Aim: Patients with chronic liver disease (CLD) requiring surgical intervention have a higher risk of postoperative complications and liver decompensation. We evaluated the early postoperative outcome of patients with CLD undergoing non-hepatic surgery. Methods: The records of all patients with CLD who underwent non-hepatic surgery in the Department of Gastrointestinal Surgery and Liver Transplantation, All India Institute of Medical Sciences, New Delhi from May 1985 to March 2015 were retrieved from a prospectively maintained database. Statistical analysis was done using SPSS software (version 17.0; SPSS Inc., Chicago, IL, USA). Results: One hundred and eighty-five patients with CLD (mean age 39.5 + 14.8 years; male:female 137:48) underwent non-hepatic surgery (elective 116; emergency 69) during the specified time period. Hepatitis B and C virus infection (30.8%) and alcohol (17.8%) were the most common causes of CLD. The in-hospital mortality (44.9% vs 7.8%; P = 0.0001), morbidity (78.5% vs 51.7%; P = 0.0001), postoperative liver decompensation (43.1% vs 12.2%; P = 0.0001), ascites (65.2% vs 36.5%; P = 0.0001) and median hospital stay [9 days (range 1–63 days) vs 7 days (range 1–33 days); P = 0.011] were significantly higher after emergency surgery as compared to elective surgery. The in-hospital mortality, morbidity, liver decompensation and ascites formation rates also significantly increased with worsening Child's status