Riesgo perioperatorio en pacientes con cirrosis hepática

Ten percent of cirrhotic patients with severely compromised liver function will require a surgical procedure. This article reviews the surgical risk associated with liver damage and surgery. The most important prognostic factor is the degree of functional impairment of the liver. It is evaluated usi...

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Autores principales:	CONCHA P,MARIO, MERTZ K,VERÓNICA
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2010
Materias:	General surgery Liver cirrhosis Survival rate
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000900013
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spelling	oai:scielo:S0034-988720100009000132010-11-09Riesgo perioperatorio en pacientes con cirrosis hepáticaCONCHA P,MARIOMERTZ K,VERÓNICA General surgery Liver cirrhosis Survival rate Ten percent of cirrhotic patients with severely compromised liver function will require a surgical procedure. This article reviews the surgical risk associated with liver damage and surgery. The most important prognostic factor is the degree of functional impairment of the liver. It is evaluated using the Child-Pugh score, which has limitations that have been partially overcome by the Model for End Stage Liver Disease (MELD) score. Cardiac surgery has the highest risk, while extra-thoracic and extra-abdominal procedures have the lowest risk. The mortality for abdominal surgery fluctuates between 11 and 76%. Biliary surgery is associated with frequent complications and mortality, which seem to decrease when the procedures are laparoscopic. There are few series that evaluate risk in Child C patients. In liver resective surgery, liver function impairment and magnitude of the excision determine the risk. A high serum creatinine, cardiac failure and emergency surgery are independent risk factors. Although MELD score is useful to predict surgical risk, decision-making must be based on an individualized evaluation of each patient and careful planning of surgical procedures.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.138 n.9 20102010-09-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000900013es10.4067/S0034-98872010000900013
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	General surgery Liver cirrhosis Survival rate
spellingShingle	General surgery Liver cirrhosis Survival rate CONCHA P,MARIO MERTZ K,VERÓNICA Riesgo perioperatorio en pacientes con cirrosis hepática
description	Ten percent of cirrhotic patients with severely compromised liver function will require a surgical procedure. This article reviews the surgical risk associated with liver damage and surgery. The most important prognostic factor is the degree of functional impairment of the liver. It is evaluated using the Child-Pugh score, which has limitations that have been partially overcome by the Model for End Stage Liver Disease (MELD) score. Cardiac surgery has the highest risk, while extra-thoracic and extra-abdominal procedures have the lowest risk. The mortality for abdominal surgery fluctuates between 11 and 76%. Biliary surgery is associated with frequent complications and mortality, which seem to decrease when the procedures are laparoscopic. There are few series that evaluate risk in Child C patients. In liver resective surgery, liver function impairment and magnitude of the excision determine the risk. A high serum creatinine, cardiac failure and emergency surgery are independent risk factors. Although MELD score is useful to predict surgical risk, decision-making must be based on an individualized evaluation of each patient and careful planning of surgical procedures.
author	CONCHA P,MARIO MERTZ K,VERÓNICA
author_facet	CONCHA P,MARIO MERTZ K,VERÓNICA
author_sort	CONCHA P,MARIO
title	Riesgo perioperatorio en pacientes con cirrosis hepática
title_short	Riesgo perioperatorio en pacientes con cirrosis hepática
title_full	Riesgo perioperatorio en pacientes con cirrosis hepática
title_fullStr	Riesgo perioperatorio en pacientes con cirrosis hepática
title_full_unstemmed	Riesgo perioperatorio en pacientes con cirrosis hepática
title_sort	riesgo perioperatorio en pacientes con cirrosis hepática
publisher	Sociedad Médica de Santiago
publishDate	2010
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000900013
work_keys_str_mv	AT conchapmario riesgoperioperatorioenpacientesconcirrosishepatica AT mertzkveronica riesgoperioperatorioenpacientesconcirrosishepatica
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Riesgo perioperatorio en pacientes con cirrosis hepática

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