For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
7
views
57
references
 Top references
cited by
11
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      426
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: not found

      Non-Hepatic Abdominal Surgery in Patients with Cirrhotic Liver Disease

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Cirrhotic liver disease is an important cause of peri-operative morbidity and mortality in general surgical patients. Early recognition and optimization of liver dysfunction is imperative before any elective surgery. Patients with MELD <12 or classified as Child A have a higher morbidity and mortality than matched controls without liver dysfunction, but are generally safe for elective procedures with appropriate patient education. Patients with MELD >20 or classified as Child C should undergo transplantation before any elective procedure given mortality exceeds 40%. Laparoscopic procedures are feasible and safe in cirrhotic patients.

          Related collections

          Most cited references57

          • Record: found
          • Abstract: found
          • Article: not found

          Pathogenesis of liver cirrhosis.

          Wen-Ce Zhou, Quan-Bao Zhang, Liang Qiao (2014)
          Liver cirrhosis is the final pathological result of various chronic liver diseases, and fibrosis is the precursor of cirrhosis. Many types of cells, cytokines and miRNAs are involved in the initiation and progression of liver fibrosis and cirrhosis. Activation of hepatic stellate cells (HSCs) is a pivotal event in fibrosis. Defenestration and capillarization of liver sinusoidal endothelial cells are major contributing factors to hepatic dysfunction in liver cirrhosis. Activated Kupffer cells destroy hepatocytes and stimulate the activation of HSCs. Repeated cycles of apoptosis and regeneration of hepatocytes contribute to pathogenesis of cirrhosis. At the molecular level, many cytokines are involved in mediation of signaling pathways that regulate activation of HSCs and fibrogenesis. Recently, miRNAs as a post-transcriptional regulator have been found to play a key role in fibrosis and cirrhosis. Robust animal models of liver fibrosis and cirrhosis, as well as the recently identified critical cellular and molecular factors involved in the development of liver fibrosis and cirrhosis will facilitate the development of more effective therapeutic approaches for these conditions.
          Article 0 comments Cited 198 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Risk factors for mortality after surgery in patients with cirrhosis.

            Jamie R Stevens, Kenneth Offord, J A Talwalkar … (2007)
            Current methods of predicting risk of postoperative mortality in patients with cirrhosis are suboptimal. The utility of the Model for End-stage Liver Disease (MELD) in predicting mortality after surgery other than liver transplantation is unknown. The aim of this study was to determine the risk factors for postoperative mortality in patients with cirrhosis. Patients with cirrhosis (N = 772) who underwent major digestive (n = 586), orthopedic (n = 107), or cardiovascular (n = 79) surgery were studied. Control groups of patients with cirrhosis included 303 undergoing minor surgical procedures and 562 ambulatory patients. Univariate and multivariable proportional hazards analyses were used to determine the relationship between risk factors and mortality. Patients undergoing major surgery were at increased risk for mortality up to 90 days postoperatively. By multivariable analysis, only MELD score, American Society of Anesthesiologists class, and age predicted mortality at 30 and 90 days, 1 year, and long-term, independently of type or year of surgery. Emergency surgery was the only independent predictor of duration of hospitalization postoperatively. Thirty-day mortality ranged from 5.7% (MELD score, 20). The relationship between MELD score and mortality persisted throughout the 20-year postoperative period. MELD score, age, and American Society of Anesthesiologists class can quantify the risk of mortality postoperatively in patients with cirrhosis, independently of the procedure performed. These factors can be used in determining operative mortality risk and whether elective surgical procedures can be delayed until after liver transplantation.
            Article 0 comments Cited 89 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found

              Management of the critically ill patient with cirrhosis: A multidisciplinary perspective.

              Mitra Nadim, François Durand, John A. Kellum … (2016)
              Article 0 comments Cited 84 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                Selwyn Vickers:
                ORCID: http://orcid.org/0000-0003-3133-5543
                205.934.9447 , smv@uab.edu
                Journal
                Journal ID (nlm-ta): J Gastrointest Surg
                Journal ID (iso-abbrev): J. Gastrointest. Surg
                Title: Journal of Gastrointestinal Surgery
                Publisher: Springer US (New York )
                ISSN (Print): 1091-255X
                ISSN (Electronic): 1873-4626
                Publication date (Electronic): 21 November 2018
                Publication date (Print): 2019
                Volume: 23
                Issue: 3
                Pages: 634-642
                Affiliations
                [1 ]ISNI 0000000106344187, GRID grid.265892.2, Department of Surgery, Division of Gastrointestinal Surgery, , University of Alabama at Birmingham, ; Birmingham, AL USA
                [2 ]Division of Acute Care Surgery, Birmingham, USA
                [3 ]ISNI 0000000106344187, GRID grid.265892.2, Dean’s Office, , UAB School of Medicine, ; FOT 1203, 510 20th Street South, Birmingham, AL 35233 USA
                Author notes
                [Disclosure Information]

                Authors: Laura Hickman, MD, has nothing to disclose; Lauren Tanner, MD, has nothing to disclose; John Christein, MD, has nothing to disclose; Selwyn Vickers, MD, has nothing to disclose. Editors-in-Chief: Richard A. Hodin, MD, and Timothy M. Pawlik, MD, MPH, PhD, have nothing to disclose. CME overseers: Arbiter: Timothy M. Pawlik, MD, MPH, PhD, has nothing to disclose; Vice-arbiter: Melanie Morris, MD, has nothing to disclose; Question reviewers: Marco Fisichella, MD, has nothing to disclose; Ron Landmann, MD, has nothing to disclose.

                CME questions for this article available to SSAT members at http://ssat.com/jogscme/

                Author information
                http://orcid.org/0000-0003-3133-5543
                Article
                Publisher ID: 3991
                DOI: 10.1007/s11605-018-3991-7
                PMC ID: 7102012
                PubMed ID: 30465191
                SO-VID: 0caef318-e25b-4b4e-9daa-c981358ca74f
                Copyright © © The Society for Surgery of the Alimentary Tract 2018
                License:

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                Date received : 28 September 2017
                Date accepted : 20 September 2018
                Categories
                Subject: Evidence-Based Current Surgical Practice
                Custom metadata
                issue-copyright-statement © The Society for Surgery of the Alimentary Tract 2019

                ScienceOpen disciplines: Surgery
                Keywords: abdominal surgery,chronic liver disease,cirrhosis,appropriate surgical decision making,postoperative care
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: abdominal surgery, chronic liver disease, cirrhosis, appropriate surgical decision making, postoperative care

                Comments

                Comment on this article

                scite_

                Similar content426

                See all similar

                Cited by11

                See all cited by

                Most referenced authors630

                See all reference authors