Umbilical herniorrhaphy in cirrhotic patients

Area of Science:

• Gastroenterology
• Hepatology
• General Surgery

Background:

• Umbilical hernias are common surgical issues.
• Cirrhotic patients with ascites present unique surgical challenges.
• Peritoneovenous shunts are used to manage ascites.

Purpose of the Study:

• To evaluate the outcomes of umbilical herniorrhaphy in cirrhotic patients with ascites.
• To compare outcomes based on the presence and function of peritoneovenous shunts.
• To determine the optimal surgical approach for these patients.

Main Methods:

• Retrospective chart analysis of 92 patients undergoing umbilical herniorrhaphy over ten years.
• Patients categorized into three groups: cirrhotic with functioning shunts, cirrhotic without functioning shunts, and non-cirrhotic.
• Outcomes assessed included postoperative mortality, morbidity, and hernia recurrence.

Main Results:

• Umbilical hernia repair in cirrhotic patients with uncontrolled ascites was linked to significant mortality (8.3%), morbidity (16.6%), and recurrence (16.6%).
• Patients with functioning peritoneovenous shunts experienced minimal morbidity (7%).
• Non-cirrhotic patients had lower rates of complications and recurrence.

Conclusions:

• Umbilical hernia repair in cirrhotic patients with ascites is associated with increased risks.
• Peritoneovenous shunting prior to umbilical herniorrhaphy may improve outcomes in cirrhotic patients with ascites.
• This approach can reduce postoperative complications and hernia recurrence.