For general surgeons, the early recognition of acute liver failure is as important as early referral to a tertiary unit, preferably a liver transplant unit, will facilitate medical management and provide the opportunity for liver transplantation. In Western countries, the most common cause is an overdose of acetaminophen, while in Asia and Africa, the most common cause is viral hepatitis, particularly hepatitis B. In chronic liver disease, the focus is on the management of complications of cirrhosis [decompensated cirrhosis] including bleeding varices, ascites, spontaneous bacterial peritonitis and hepatic encephalopathy. There is also the issue of risks of elective and emergency surgery in patients known to have liver disease including cirrhosis.
Acute liver failure Chronic liver failure Management of liver failure Prognosis of liver failure Complications of liver cirrhosis Child-Pugh classification MELD score
This is a preview of subscription content, log in to check access.
D’Amico G, Pasta I, Morabito A, et al. Competing risks and prognostic stages of cirrhosis: a 25 year study. Aliment Pharmacol Ther. 2014;39:1180–93.CrossRefGoogle Scholar
EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis and hepatorenal syndrome in cirrhosis. J Hepatol. 2010;53:397–417.Google Scholar
EASL clinical practical guidelines on the management of acute [fulminant] liver failure. J Hepatol. 2017;66:1047–81.Google Scholar
Flamm SL, Yang YX, Singh S, Falck-Ytter YT, AGA Institute Clinical Guidelines Committee. American Gastroenterological Association Institute Guidelines for the Diagnosis and Management of Acute Liver Failure. Gastroenterology. 2017;152:644–7.CrossRefGoogle Scholar
Garcia-Pagan JC, Gracia-Sancho J, Bosch J. Functional aspects on the pathophysiology of portal hypertension in cirrhosis. J Hepatol. 2012;57:458–61.CrossRefGoogle Scholar
Seo YS, Park SY, Kim MY, et al. Lack of difference among terlipressin, somatostatin and octreotide in the control of acute gastroesophageal variceal haemorrhage. Hepatology. 2014;60:954–63.CrossRefGoogle Scholar