The Surgical Risk in Patients with Liver Disease

Lee, June Sung

Abstract

Surgical procedures and administration of anesthesia can reduce blood flow to the liver. The reduction in blood flow can result in asymptomatic elevation of serum liver biochemical tests postoperatively in patients with normal liver function, but in patients with compromised liver function, hepatic decompensation can occur, leading to morbidity and mortality. Liver disease is common and patients with liver disease are frequently asymptomatic, the preoperative assessment of all patients undergoing surgery must do a careful history and physical examination to uncover risk factors and evidence of liver dysfunction. Operative risk correlates with the severity of the underlying liver disease and the nature of the surgical procedure. This review will consider the factors that contribute to peri-operative hepatic dysfunction and prediction of operative risk in patients with liver disease undergoing surgery other than liver transplantation.