Preoperative Considerations in Patients with Advanced Liver Disease

• Published in: Middle East journal of digestive diseases Vol. 11; no. 4; pp. 237 - 240
• Main Authors: Aminnejad, Reza, Alemi, Faezeh, Safari, Saeid, Hormati, Ahmad, Ghadir, Mohammad Reza, Saeedi, Mohammad, Afifian, Mahboobeh
• Format: Journal Article
• Language: English
• Published: Iran Shiraz University of Medical Sciences 01-10-2019; Iranian Association of Gastroerterology and Hepatology
• Subjects: Anesthesia; Cardiomyopathy; Chronic obstructive pulmonary disease; Drug dosages; Dyspnea; Electrolytes; Hepatitis; Liver cirrhosis; Liver diseases; Metabolism; Mortality; Patients; Risk assessment; Surgery; Middle East; Iran
• ISSN: 2008-5230; 2008-5249
• DOI: 10.15171/mejdd.2019.156

Liver cirrhosis is defined as the advanced stage of liver disease, which presents with loss of normal hepatic tissue and its replacement by fibrotic tissue. It leads to alteration in all liver functions including metabolic, synthetic, and coagulative function. Besides, accumulation of toxins may alter mental status. This pathogenesis alters the metabolism of many drugs, so that they should be used carefully or will need dose adjustment.1A necessity for anesthesia and surgery, for liver related or unrelated indications, is a challenging issue in the management of patients with cirrhosis. This would be the art of a gastroenterologist to assess the present situation of the patient and weigh the risks and benefits to help the anesthesiologist and the surgeon in making the best plan.2The final decision will be made upon the liver disease situation and the necessity and urgency of the surgical procedure. However, even in an acceptable anesthesiological and surgical risk background, considering some points before, during, and after the procedure is necessary to minimize the complications.