Incidence and outcomes of postoperative complications after liver cirrhosis - related surgery

Aim: To investigate incidence and outcomes of postoperative complications after cirrhosis-related surgery.

Materials and Methods: Retrospective review of medical records of 344 liver cirrhosis (LC) patients who underwent cirrhosis-related surgical treatment was done. Types and incidence of postoperative complications, causes of death in operated patients, incidence of postoperative complications and mortality based on type of surgery were determined.

Results: Postoperative complications developed in 108 (31.4%) patients. Acute-on-chronic liver failure (ACLF) developed in 60 (17.4%) patients was the most common complication. ACLF was the main cause of death - 28 (49.1%) patients with developed complications died. The lowest number of postoperative complications and the lowest mortality were observed after extraperitonization of right hepatic lobe with intraoperative laser irradiation: complications developed in 3 (9.1%) patients, 1 (3.0%) patient died. Complications after endoscopic interventions developed in 10 (15.4%) patients, 6 (9.2%) died, after roentgen-endovascular interventions complications developed in 10 (15.4%) patients, all of them died. Devascularization and transection interventions complications developed in 31 (31.0%) patients, 21 (21%) died. In patients, who underwent distal splenorenal shunt - complications developed in 54 (66.7%) patients, 19 (23.4%) patients died.

Conclusions: The most common complication of the early postoperative period after LC-related surgery is ACLF, which develops in 17.4% of patients and is the cause of death in 49.1% of cases. The incidence and outcomes of postoperative complications of cirrhosis-related surgery, depends on the liver function, timing and type of surgery.