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Role of Minimally Invasive Surgery in Patients with Cirrhosis

Chapter

Abstract

Patients with cirrhosis and portal hypertension are at increased risk of complications when undergoing surgery in the elective and acute setting for nonliver disease processes. When surgery is necessary in such patients many have previously advocated for traditional open surgery as it was felt that the risk of uncontrolled bleeding with laparoscopy was prohibitive. Recently, increased experience and expertise in laparoscopy, endoscopy, and other minimally invasive interventions has led to a re-evaluation of these ideas. Increasingly, laparoscopic and endoscopic techniques are being utilized in patients with cirrhosis and portal hypertension to ever-greater effect. While such patients still constitute a high-risk population for surgery, the role and utility of minimally invasive surgical techniques continues to grow for these patients. Here we discuss the current knowledge on laparoscopic and endoscopic interventions for cirrhotic patients undergoing general, liver/hepatobiliary, and bariatric surgery as well as newly emerging endoscopic techniques.

Keywords

Cirrhosis Minimally invasive surgery Endoscopy Laparoscopy Liver disease Portal hypertension 

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of General SurgeryDigestive Disease Surgical Institute, Cleveland Clinic FoundationClevelandUSA
  2. 2.Lerner College of Medicine, Department of General Surgery, Digestive Diseases Surgical InstituteCleveland Clinic FoundationClevelandUSA
  3. 3.Cleveland Clinic Lerner College of Medicine, Digestive Disease and Surgery InstituteClevelandUSA

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