Surgery and patients with cirrhosis

Perioperative surgical and anaesthetic complications (eg ascites, encephalopathy) and mortality are higher in patients with cirrhosis. The risks and benefits of surgery should be carefully assessed in patients with cirrhosis—seek specialist advice. Factors that may influence the decision-making process include the nature of the surgery, liver function, nutritional status and frailty.

Careful monitoring and individualised management are required for patients with cirrhosis who undergo surgery; for example, consider the sodium content of fluids, adjust doses of analgesia and sedation, and avoid postoperative constipation.