Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Jul 3:12:goae071.
doi: 10.1093/gastro/goae071. eCollection 2024.

Preoperative risk evaluation and optimization for patients with liver disease

Sameer Bhalla  1 , Brendan Mcquillen  1 , Edward Cay  1 , Nancy Reau  2
Affiliations
Review

Preoperative risk evaluation and optimization for patients with liver disease

Sameer Bhalla et al. Gastroenterol Rep (Oxf). .

Abstract

The prevalence of liver disease is rising and more patients with liver disease are considered for surgery each year. Liver disease poses many potential complications to surgery; therefore, assessing perioperative risk and optimizing a patient's liver health is necessary to decrease perioperative risk. Multiple scoring tools exist to help quantify perioperative risk and can be used in combination to best educate patients prior to surgery. In this review, we go over the various scoring tools and provide a guide for clinicians to best assess and optimize perioperative risk based on the etiology of liver disease.

Keywords: acute hepatitis; chronic liver disease; surgical complications.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Figure 1.
Figure 1.
Approach to patients with liver disease undergoing surgery. aHigh-risk procedures include open abdominal, cardiothoracic, major orthopedic, and abdominal wall surgery. CBC = complete blood count, CMP = comprehensive metabolic panel, INR = international normalized ratio, MELD = Model for End-Stage Liver Disease, CPS = Child–Pugh score, MRS = Mayo Risk Score, VPS = VOCAL-PENN score, ADOPT-LC = Adequate Operative Treatment for Liver Cirrhosis, HFRS = Hospital Frailty Risk Score.
See this image and copyright information in PMC

References

    1. Cheemerla S, Balakrishnan M.. Global epidemiology of chronic liver disease. Clin Liver Dis (Hoboken) 2021;17:365–70. doi:10.1002/cld.1061 - DOI - PMC - PubMed
    1. Vos T, Lim SS, Abbafati C. et al.; GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020;396:1204–22. doi:10.1016/S0140-6736(20)30925-9 - DOI - PMC - PubMed
    1. Kabbany MN, Conjeevaram Selvakumar PK, Watt K. et al. Prevalence of nonalcoholic steatohepatitis-associated cirrhosis in the united states: an analysis of national health and nutrition examination survey data. Am J Gastroenterol 2017;112:581–7. doi:10.1038/ajg.2017.5 - DOI - PubMed
    1. Tessiatore KM, Mahmud N.. Trends in surgical volume and in-hospital mortality among United States cirrhosis hospitalizations. Ann Gastroenterol 2021;34:85–92. doi:10.20524/aog.2020.0554 - DOI - PMC - PubMed
    1. Mahmud N, Fricker Z, Serper M. et al. In-Hospital mortality varies by procedure type among cirrhosis surgery admissions. Liver Int 2019;39:1394–9. doi:10.1111/liv.14156 - DOI - PMC - PubMed

LinkOut - more resources