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[Umbilical and inguinal hernioplasty in cirrhotic patients]
R Zepeda1, M F Herrera, M A Mercado
1Departamento de Cirugía, Instituto Nacional de la Nutrición Salvador Zubirán, Tlalpan, México, D.F. México.
Insights
Surgical repair of abdominal wall hernias in cirrhotic patients is feasible. Herniorrhaphy is recommended for symptomatic patients with good liver function, balancing risks and benefits.
Area of Science:
- Hepatology
- Gastroenterology
- Surgical Oncology
Context:
- Abdominal wall hernias are common in patients with hepatic cirrhosis.
- Surgical intervention for hernias in this population presents unique challenges due to impaired liver function and potential complications.
- Previous studies have yielded varied outcomes regarding the safety and efficacy of herniorrhaphy in cirrhotic patients.
Purpose:
- To assess the overall results of surgical treatment for abdominal wall hernias in patients with hepatic cirrhosis.
- To evaluate the operative mortality and postoperative complications associated with herniorrhaphy in cirrhotic individuals.
- To determine the optimal patient selection criteria for herniorrhaphy in the context of liver cirrhosis.
Summary:
- A retrospective study analyzed 41 cirrhotic patients who underwent 22 umbilical and 22 inguinal herniorrhaphies between 1982 and 1992.
- Patients were stratified by Child-Pugh classification (A, B, C), with 19 exhibiting clinical ascites.
- Operative mortality was 5% (two Child-Pugh C cases), and 10 patients experienced postoperative complications, primarily surgical wound issues.
Impact:
- The study suggests herniorrhaphy can be recommended for symptomatic cirrhotic patients with preserved hepatic function.
- Findings guide surgical decision-making, emphasizing careful patient selection to minimize risks in this vulnerable population.
- This research contributes to understanding the management of abdominal wall hernias in patients with liver disease.
Abstract:
The overall results of surgical treatment of abdominal wall hernias in patients with hepatic cirrhosis were assessed by a retrospective study in 41 cirrhotic patients. They underwent 22 umbilical and 22 inguinal herniorrhapies between 1982 and 1992. Sixteen patients were classified as Child-Pugh A, 16 as B and 9 as C. Clinical evidence of ascitis was documented in 19 patients. The operative mortality was 5% (two Child-Pugh C cases). Postoperative complications occurred in 10 patients, most of them related to the surgical wound. We recommend herniorraphy in symptomatic cirrhotic patients but with fairly good hepatic function.