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Perioperative Management of the Cirrhotic Patient

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Common Problems in Acute Care Surgery

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Abstract

The management of acute surgical pathologies in patients with advanced liver disease can be challenging for even the most experienced surgeon. Appropriate surgical decision making requires an understanding of not only the surgical problem itself, but also the physiologic and anatomic changes that accompany chronic liver disease. As the medical management of patients with advanced liver disease improves, the prevalence of cirrhosis in the general population is increasing. Cirrhotics represent an estimated 0.27 % of the population, approximately 633,323 adults in the USA (Scaglione and Kliethermes, J Clin Gastroenterol 49:690–6, 2015). Accordingly, surgeons can expect to see an increase in the number of cirrhotics requiring acute surgical care and must be prepared to handle these complex patients. This chapter describes issues related to the acutely presenting patient with chronic liver disease. Overviews of the management of cirrhotics presenting for elective non-hepatic surgery are available elsewhere (Mansour et al., Surgery 122:730–5, 1997).

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Author information

Authors and Affiliations

  1. Department of Surgery, The University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 6.254, Houston, TX, 77030, USA

    Maamoun A. Harmouch

  2. Department of Surgery and Internal Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 6.254, Houston, TX, 77030, USA

    Mark J. Hobeika

Authors
  1. Maamoun A. Harmouch
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Correspondence to Mark J. Hobeika .

Editor information

Editors and Affiliations

  1. Department of Surgery, The University of Texas McGovern Medical School - Houston, Houston, Texas, USA

    Laura J. Moore

  2. General Surgery and Trauma Ben Taub Hospital, Houston, Texas, USA

    S. Rob Todd

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Harmouch, M.A., Hobeika, M.J. (2017). Perioperative Management of the Cirrhotic Patient. In: Moore, L., Todd, S. (eds) Common Problems in Acute Care Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-42792-8_4

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  • DOI: https://doi.org/10.1007/978-3-319-42792-8_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-42790-4

  • Online ISBN: 978-3-319-42792-8

  • eBook Packages: MedicineMedicine (R0)

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