[Chest surgery in patients with liver disease]

Although surgery is contraindicated in patients with acute hepatic disorders such as acute hepatitis and acute liver failure, elective surgery might be well tolerated to the patients with non-cirrhotic liver diseases. Operative risk in patients with liver cirrhosis correlates with the severity of liver damage. Several well-known scoring systems for the assessment of cirrhotic severity such as Child-Pugh classification might be useful for the risk prediction in major abdominal surgery. However, there were few data concerning the risk prediction for general non-cardiac thoracic surgery. Clinical manifestations due to liver cirrhosis including hypoalbuminemia, bleeding tendency, ascites, infection, encephalopathy, should be thoroughly evaluated and optimally treated during perioperative period. Furthermore, careful intraoperative procedures are needed for both hemostasis and wound healing.