[Results of abdominal operations in patients with liver cirrhosis]

A retrospective analysis was done of 45 patients with cirrhosis who were operated on for abdominal diseases and their complications, mainly cholelithiasis. Out of seven studied risk factors, of greatest importance were serum albumin deficiency which appeared in 45% of patients and was fraught with 100% mortality, prothrombin time (in 40%-89% mortality), and jaundice (25%-82% mortality). Postoperative complications occurred in 71% of patients with cirrhosis, mainly hepatic coma (22%), sepsis (35%), haemorrhage (18%), and eventration (22%). Postoperative mortality was 64.5%, including 76% after emergency operations, and 54% after elective surgery. After operations on the bile ducts 55% patients died. So the operations should not be performed in asymptomatic cholelithiasis during cirrhosis since there is no evidence that it deteriorates the patients' condition, and the mortality is very high. The causes are discussed of poor prognosis after surgery in cirrhosis, as well as the principles of management which may contribute to reduction of the number of complications and to a drop in mortality.