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AI-Generated response:

What are the potential postoperative complications in patients with liver disease?

Answer generated on June 5, 2024

The AI-generated responses are for illustration purposes only and should not be used for medical purposes.

Patients with liver disease may experience various postoperative complications including delirium, particularly in those with alcohol-related hepatitis, and issues related to volume status, clotting disorders, and potential encephalopathy.[1]

  • Delirium can occur due to underlying causes of liver disease such as alcohol-related hepatitis.

  • Management of volume status is crucial, especially in controlling ascites which is common in liver disease.

  • Coagulopathy may arise due to impaired synthesis of clotting factors by the diseased liver.

  • Encephalopathy, a serious complication, needs careful monitoring and management.

  • The severity of these complications often correlates with the MELD score, which quantifies the severity of liver disease.[1]

Additional info

In managing patients with liver disease undergoing surgery, it is essential to consider the increased risk of postoperative complications. These complications can significantly impact the morbidity and mortality associated with surgical procedures in this patient population. The MELD score is particularly useful in assessing the risk and guiding perioperative management strategies to mitigate these risks. Effective management includes careful monitoring of liver function, fluid balance, and neurological status, along with appropriate adjustments in medication and interventions to manage complications such as ascites and encephalopathy.

References

Reference 1

1.

Auerbach, Andrew D. (2024). In Goldman-Cecil Medicine (pp. 2659). DOI: 10.1016/B978-0-323-93038-3.00399-3

Patients with asymptomatic or mild chronic hepatitis or other liver disease do not require specific preoperative testing beyond what is routinely indicated. However, such patients may be at higher risk for postoperative complications due in part to the causes of their liver disease (e.g., delirium in patients with alcohol-related hepatitis).Outcomes of patients with cirrhosis tend to correlate with the severity of their liver disease as quantified by Model for End-Stage Liver Disease (MELD) score (Table 139-2).The focus in such patients should be on managing volume status (particularly ascites), clotting disorders, and potential encephalopathy (Chapter 139).

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