The Patient with Liver Disease Undergoing Non-hepatic Surgery

  • Katherine Palmieri
  • Robert N. Sladen


It has been estimated that 5–10% of all patients with cirrhosis of the liver will undergo surgery other than liver transplantation during their last 2 years of life [1]. Patients with any form of severe liver disease who undergo non-hepatic surgery are at markedly increased risk of perioperative complications and mortality [2, 3, 4, 5, 6, 7] and pose a substantial perioperative challenge to anesthesiologist. The myriad manifestations of liver disease and its high operative risk imply that surgery should never be taken lightly in this group of patients.

The Impact of Liver Disease on Perioperative Outcome

Events that most commonly contribute to morbidity and mortality include bleeding, sterile or infected ascites, pulmonary or genitourinary sepsis, decompensated liver failure and/or severe acute kidney injury (AKI) [8, 9, 10, 11]. In a 2014 study of 194 patients with cirrhosis undergoing abdominal surgery, Neeff et al. observed that 69% had a postoperative complication. Of...


Non-hepatic surgery Perioperative outcome Preoperative Evaluation Anesthetic Management Abdominal surgery Cardiothoracic surgery 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of AnesthesiologyThe University of Kansas Health SystemKansas CityUSA
  2. 2.Allen Hyman Professor Emeritus of Critical Care Anesthesiology at Columbia University Medical CenterCollege of Physicians and Surgeons of Columbia UniversityNew YorkUSA

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