Surgical Approach to Cirrhotic Patients

Patients with liver disease, and those with cirrhosis in particular, have long been among the most complex and difficult to manage for healthcare providers of all specialties. For surgeons, this diagnosis alone can be enough to cause even the most aggressive to take pause when considering operative intervention. Unfortunately, this all-too-common affliction is ever-present and often exacerbates other underlying conditions to the point of needing surgical intervention. Cirrhotic patients who undergo non-hepatic operations demonstrate increased in-hospital mortality of 8-25% compared to 1.1% mortality in non-cirrhotic patients. Appropriate perioperative planning and meticulous post-operative management can result in successful navigation of this subset of patients through the perils of this crucial period to provide beneficial and life-saving interventions.