Surgery in patients with portal hypertension: A preoperative checklist and strategies for attenuating risk

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Abstract

Patients with liver disease and portal hypertension are at increased risk of complications from surgery. Recent advances have allowed better optimization of patients with cirrhosis before surgery and a reduction in postoperative complications. Despite this progress, the estimation of surgical risk in a patient with cirrhosis is challenging. The MELD score has shown promise in predicting postoperative mortality compared with the Child-Turcotte-Pugh score. This article addresses current concepts in the perioperative evaluation of patients with liver disease and portal tension, including a preoperative liver assessment (POLA) checklist that may be useful towards mitigating perioperative complications.

Original languageEnglish
Pages (from-to)477-505
Number of pages29
JournalClinics in Liver Disease
Volume18
Issue number2
DOIs
StatePublished - May 2014

Keywords

  • Ascites
  • Checklist
  • Child-Turcotte-Pugh
  • Cirrhosis
  • MELD
  • Portal hypertension
  • Surgery
  • TIPS
  • Variceal bleeding

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