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Hernia Repair in Patients with Cirrhosis

  • Richard Smith
Chapter

Abstract

Hernia repair in patients with cirrhosis has historically been associated with significant morbidity and mortality. However, with careful consideration and in well-selected patients, the morbidity and mortality can be acceptable. Some studies have shown worse outcomes for patients undergoing emergent repairs when compared to elective repair. This has prompted some authors to recommend elective repair broadly. However, the differences in outcome between elective repair and emergent repair appear to be more related to the underlying degree of liver dysfunction than acuteness of the indication. Therefore, degree of liver dysfunction, physiologic status, and comorbidities should be weighed carefully. Referral to specialized centers (transplant centers) with a multidisciplinary team who can assist in perioperative care of the patient undergoing hernia repair should also be considered. In patients undergoing surgery, the risk of recurrence and complications can be reduced by maximizing medical treatment of ascites, assessing nutrition, and careful surveillance for infection prior to operation.

Keywords

Cirrhosis Umbilical hernia Ruptured umbilical hernia Ascites Inguinal hernia Ventral hernia Liver transplantation 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Richard Smith
    • 1
  1. 1.Department of SurgeryUniversity of MissouriColumbiaUSA

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